Painful Dream of Motherhood: A Hermeneutic Phenomenological Study of Married Women with Ectopic Pregnancy in the Islamic Republic of Iran.

Ectopic pregnancy (EP) is a significant cause of maternal morbidity and mortality. This study aimed to explore the understanding and experience of women with EP in the Islamic Republic of Iran. This qualitative study carried out through a Heideggerian hermeneutic/interpretative phenomenological approach, using face-to-face semi-structured phenomenological interviews with twenty-five participants referred to a public maternity hospital in Rasht, Iran. Data were collected and analyzed using the seven-step analytical approach of Dickelman et al. (The NLN criteria of appraisal of baccalaureate programs: A critical hermeneutic analysis, NLN Press, 1989; Journal of Nursing Education. 32:245-250, 1993) to phenomenological studies. The results reveal how living in the shadow of Islamic Sharia Law in Iran turns EP into a trauma and creates a different experience and meaning of EP for each woman. In this view, multiple factors, including 'family support' and 'faith in Islamic Sharia,' have determined how married women experience sociocultural and psychological consequences of EP. These findings apply to women with EP in Iran. Given that EP is more than an anomalous pregnancy with socially culturally constructed suffering in the context of the Islamic Republic of Iran. Hence, policymakers and healthcare providers should consider a multidimensional approach to this devastating event in pregnancy and support and empower the women whose dream of motherhood is jeopardized and terminated by the experience of EP.

Interleukin-17, C-reactive protein, Neutrophil-to-Lymphocyte ratio, Lymphocyte-to-Monocyte ratio, and lipid profiles in healthy menopausal women with or without hot flashes: A cross-sectional study.

INTRODUCTION: The reciprocation between systemic inflammatory markers (SIMs), dyslipidemia, and hot flashes (HFs) can play a part in the pathogenesis of endothelial dysfunction through menopause. This study intended to determine the association between some SIMs, lipids, and HFs in healthy menopausal women. MATERIALS AND METHODS: We designed a cross-sectional study in which 160 healthy menopausal women aged 40-60 were enrolled. Concerning their HFs status, they were stratified into two groups by consecutive sampling: without HFs (n = 40) and with HFs (n = 120). In addition to clinical variables and HFs experience, we measured the fasting serum levels of SIMs and lipid profiles (LPs), including Interleukin-17 (IL-17), high- sensitivity C-Reactive Protein (hs-CRP), Total Cholesterol (TC), Triglycerides (TG), Low-Density Lipoprotein Cholesterol (LDL-C), and High-Density Lipoprotein Cholesterol (HDL-C) in each group. Then, we calculated TC/HDL-C concerning the related variables and determined Neutrophil-to-Lymphocyte Ratio (NLR), and Lymphocyte-to-Monocyte Ratio (LMR), according to Complete Blood Count (CBC) quantitative parameters in each group. Furthermore, we used logistic regression analysis to assess the association between SIMs, LPs, and HFs. SETTINGS: We performed this study in a governmental teaching hospital, Guilan/Rasht, Iran, from April to September 2021. RESULTS: The two groups of menopausal women without and with HFs were not significantly different regarding the median of IL-17, hs-CRP, NLR, LMR, TG, HDL-C, and TC/HDL-C, and the mean of TC and LDL-C. Based on multiple logistic regression, TG levels appeared to be associated with the incidence of HFs (B = 0.004, P = 0.040, Odds Ratio:1.004, 95%CI:1.000-1.009). NLR seemed to have an increasing impact on the HFs severity, according to ordinal logistic regression (B = 0.779, P = 0.005, Odds Ratio = 2.180, 95%CI:1.270-3.744). Furthermore, hs-CRP negatively correlated with TG (r = -0.189, P = 0.039) and TC/HDL-C (r = -0.268, P = 0.003) in menopausal women with HFs. CONCLUSION: This study indicated an association between SIMs, lipids, and HFs. These connections may suggest HFs as links between SIMs/LPs alterations and their outcomes.

Evaluation of childbirth self-efficacy and associated factors among pregnant women.

BACKGROUND: Increasing the rate of Normal Vaginal Delivery (NVD) and reducing elective cesarean section is one of the important concerns, especially in Iran. Childbirth self-efficacy can play an important role in managing the fear of childbirth and increasing the rate of NVD. The aim of this study was to determine demographic, fertility, and social factors related to childbirth self-efficacy. MATERIALS AND METHODS: The present study was a single-group, single-stage, multivariate, cross-sectional study that assessed childbirth self-efficacy and associated factors in 358 eligible pregnant women with gestational age of 37 weeks and over in Guilan (North Iranian province) from November 2018 to July 2019. Data collection was performed based on consecutive sampling method from the pregnant women referring to the prenatal clinic. Data collection tools included a demographic and reproductive characteristics questionnaire; Lowe's childbirth self-efficacy Inventory and Zimet's perceived social support multidimensional questionnaire. RESULTS: There was a significant relationship between the educational level of pregnant women and Outcome Expectancy (OE) and Self-efficacy Expectancy (EE) and also between the spousal level of education and OE (P < 0.05). Parity, previous experience of birth, participation in pregnancy preparation classes, access to information sources about childbirth, and birth preference were significantly related to OE and EE (P < 0.05). There was a significant relationship between the two domains of perceived social support, spouse and friends, and the OE and EE (P < 0.05). The multivariate logistic regression model revealed that birth preference was a predictor for OE and EE, while a pregnant woman's education level and perceived social support in the domain of significant others were predictors for OE. Spousal age, mean family income, and participation in the prenatal preparation classes were predictors for EE. CONCLUSIONS: Regarding the importance of self-efficacy in childbirth in encouraging pregnant women to perform NVD, pregnancy and childbirth preparation classes with an emphasis on concepts including self-efficacy of childbirth should be focused by midwives and other health-care workers in order to improve pregnant women's knowledge regarding the benefits of NVD and to strengthen their belief in the benefits of pain-compatible actions.

Double-Blind Controlled Trial of Vitamin E Effects on Serum Lipid Profile in Menopausal Women.

BACKGROUND: Menopause is associated with changes in lipid profile and is a known risk factor for oxidative stress. Different therapeutical strategies have been used to control menopause complications. Vitamin E, an important anti-oxidant, can possibly affect lipid peroxidation in menopausal women. Thus, we aimed to evaluate the effect of vitamin E supplementation on the lipid profile of menopausal women. MATERIALS AND METHODS: This double-blind, placebo-controlled, randomized, cross-over, phase I/II trial study was designed in two 4-week intervention phases with an 8-day washout period in between. Eighty-three natural menopause women participated in the study. Randomized block allocation was used to divide women into group A (n = 41) and group B (n = 42). In phase I, one group received vitamin E capsule (400 IU/day) and another group received placebo capsule for 4 weeks. After an 8-day washout period, phase II was initiated for a period of 4 weeks, where the group that received vitamin E capsule was given placebo (E-P) and the group that received placebo was given vitamin E (P-E). Plasma lipid profile levels (LDL-C, HDL-C, TC, and TG) were assessed before and after intervention separately in each phase and in each group. Lipid profile was measured by enzymatic colorimetric method. Data were analyzed according to the intention-to-treat principle. All statistical analyses were performed using SPSS software. RESULTS: The analysis indicated no significant difference in plasma TC, LDL-C, HDL-C, and TG levels between P-E and E-P groups before intervention in phase I and II (P > 0.05). There was no significant difference in plasma lipid profile levels within the P-E and E-P groups before and after intervention in phase I and II. There was a significant difference in plasma TG within the E-P group before [141.74 ± 53.52, 138.50 (94-195)] and after [167.47 ± 71.32, 170 (108-202)] intervention in phase II (P = 0.010). There was no significant difference in terms of the mean changes in plasma lipid profile between the P-E and E-P groups in phase I and II (P > 0.05). CONCLUSION: The study results revealed that vitamin E supplementation had no remarkable effect on the lipid profile in menopausal women.

Parents' concerns regarding the growth characteristics of their adolescents: a qualitative inquiry in Iran.

In recent times, parents have become increasingly concerned, both subjectively and objectively, about their adolescents' body height/weight growth. Parent-adolescent interactions about this issue and the potential socio-psychological consequences of such interactions should be considered as an important influencing factor on the future of adolescents' sexual and reproductive health. To achieve a greater understanding of such concerns, it is necessary to further elucidate parents' experiences on this topic, so as to expand the existing literature. This study aimed to explain the perceptions of parents' concerns regarding their adolescents' growth characteristics in the socio-cultural context of Iran as a transitional society. This paper is part of a larger qualitative study designed using the Constructivist Grounded Theory Methodology (CGTM). We conducted open-ended intensive interviews with eleven parents individually and recruited them through purposeful and theoretical sampling from a teaching hospital, community, and a primary school in Tehran with theoretical sampling variation in terms of teenagers' age, sex, and birth order, place of residence, parents' occupation and education, and the self-reported socio-economic status. Using the analytical procedures of the CGTM, we performed analyses. In the findings, the concept of 'living with constant sense of uncertainty' emerged from the subcategories including 'feeling existing and potential concern about expected minimum and maximum bio-positions of growth,' 'feeling potential concern about biological health consequences,' 'feeling potential concern about the emergence of early/late maturity signs,' 'feeling potential concern about adolescent's emotional threat,' 'feeling concerned about future employment, education, marriage, and fertility,' and 'feeling potential concern about the society's view'. These findings suggest that parents are living with a constant sense of uncertainty about their teens' growth characteristics throughout the transition from adolescence. All stakeholders including parents, health-care practitioners and policymakers, and anthropologists/sociologists should be focus on such concerns, in order to manage them and their possible socio-psychological burdens.

The association between hypogonadism symptoms with serum testosterone, FSH and LH in men.

OBJECTIVES: This study aimed to determine the relationship of hypogonadism symptoms with the levels of sex hormones in men. METHODS: This cross-sectional study was conducted on 140 men aged above 40 years. Data collections were conducted by Aging Male Scales (AMS) questionnaire and some sociodemographic variables. Then, 3 ml blood serum was sampled for testosterone (free and total), FSH and LH. Data were analyzed by descriptive and analytical statistics. RESULTS: Mean age score was 52.09 ± 7.096. There was no significant association between total score of the symptoms of hypogonadism and serum total and free testosterone level while it was shown significant association with BMI (p = .021) and occupation (p = .005). CONCLUSION: The most men experienced the symptoms of hypogonadism and the majority of the symptoms were related to psychological domain. The symptoms of hypogonadism are considered to some factors like BMI and occupation too.

Awareness and experience of andropause symptoms in men referring to health centers: a cross-sectional study in Iran.

INTRODUCTION: Andropause is a gradual process and more similar to menopause in women. Knowledge and experience of symptoms of andropause is an important discussion is in their lives. OBJECTIVES: This study aimed to determine Awareness and Experience of Andropause Symptoms in Men referring to Health Centers in Rasht, Iran. MATERIALS AND METHODS: This cross-sectional and analytical study included 140 men over 40 years referring to one of health centers. Collection tool of this study was a questionnaire consisting of three parts. The first part was about demographic characteristics, The second part was a researcher-made questionnaire, The third part was Aging Male Scales (AMS) questionnaire. Data were analyzed by descriptive and analytical statistics. RESULTS: This study showed 73.6% had experience symptoms of andropause. The mean knowledge score (of 20 score) for the 3/3 ± 4/9, with the level of education, occupation and income was statistically significant (p < 0.05). There was significant relationship the andropause symptoms with BMI and occupation (p < 0.05). CONCLUSION: Based on the results of this study, despite the fact that the majority of men over age 40 had experienced symptoms of andropause, but their awareness about andropause was very low.

Sexuality and elderly with chronic diseases: A review of the existing literature.

BACKGROUND: Increased life expectancy and the growing phenomenon of aging can lead to increased burden of chronic diseases (CDs) which adversely affects the overall health of elderly, their sexuality in particular. Sexual life of an aged population is overlooked in many of the societies. In the present narrative review, we aim to assess the impact of CDs on sexual function of elderly people. MATERIALS AND METHODS: We used internet databases including PubMed, EMBASE, ISI Web of Science, Google Scholar, SID, Iran Medex, Magiran, IPPF, and UNFPA without time limit. Ninety-eight out of 174 relevant articles were selected which met the inclusion criteria: those articles were research-based in English or Persian (original or review articles) and textbooks; specified one or more CDs and sexual function of the cases; elderly people over the age of sixty, men and women; and coordination between articles and research goals. We excluded qualitative and case studies. We reported the most related CDs with sexual function in literature review and used the biological and psychological impact of the CDs on sexual function of elderly population based on the conceptual model of Verschuren et al. (2010). RESULTS: The results of the studies were classified into the themes including physical, psychological, and cultural and social. Diabetes, cardiovascular, cancerous, and chronic respiratory diseases and also some medications can reduce sexual capacity and desire in particular resulting in negative impact on the quality of elderly sexual life. CDs may influence sexual expressions and responses which adversely affect one's mood and energy so that can cause depression and grief, as well as loss of self-confidence, self-esteem, and self-concept in elderly adults. The factors affecting sexuality of an elderly with CDs include cultural and mythical beliefs about age and illnesses, fear, and embarrass of changed physical appearance. The research conducted among elderly population examining the adverse influence of CDs on aged people's sexual life in general, sexual function and performance, and intimate interaction. CONCLUSION: It is considered that programs on sexual health needs of aged population for the health-care workers can prove beneficial in improving sexual health.