The Effect of Counseling on the Pregnant Women's Stress of Covid-19: A Clinical Trial Study.

Objective: Due to the Covid-19 pandemic crisis, which causes stress and threatens health, especially in vulnerable groups including pregnant women, the present study was conducted to determine the effect of individual counseling on the pregnant women's stress of Covid-19. Materials and methods: In this randomized controlled clinical trial, 66 pregnant women in 24 to 28 weeks were randomly divided into two groups of intervention (33 participants) and control (33 participants). At the beginning of the study, both groups completed the questionnaires of demographic information and pandemic related pregnancy test. Then, the intervention was performed in 3 sessions with the interval of one week, in the form of individual counseling by BELIFE method for the experimental group. The control group received only the routine services of the centers. The post-test was performed two weeks after the last consultation session for both groups. Data were analyzed using Stata-13 software. Significance level was considered 0.05. Results: The experimental and control groups were almost homogeneous in terms of quantitative and qualitative demographic variables. Total mean and standard deviation of stress score, before and after the intervention in the experimental group, were 40.27 ± 12.65 and 41.71 ± 1.74, respectively. These numbers in the control group were 33.84 ± 13.08 and 43.84 ± 1.69. Comparing the two groups in terms of stress score which was done after the intervention showed that although the stress score in the experimental group was lower than that in the control group, this difference was not statistically significant (p = 0.39). Conclusion: The results of this study show that although individual counseling for pregnant women was able to reduce the mean scores of stress of Covid-19 in the experimental group, this difference was not statistically significant. Therefore, although the BELIFE individual counseling method for pregnant women, who naturally suffer from pregnancy stress, is an acceptable way to reduce their stress, it is recommended to plan and implement early and more effective interventions for these women because the course of stress is severe in them and has an upward trend during Covid-19 pandemic.

The global, regional and national epidemiology, incidence, mortality, and burden of ovarian cancer.

Background: Ovarian cancer has the highest mortality rate among gynecological malignancies and is associated with poor prognosis. Since the accurate assessment of the global burden along with the trend of cancers contributes to the development of policies, this study aimed to explain the incidence, mortality, and burden of ovarian cancer using the global burden of disease (GBD) 2019 study. Methods: Epidemiological data have been collected from the study of the GBD 2019. Data were extracted globally for 204 countries and groups based on a socio-demographic index (SDI), WHO regions, continents, World Bank regions, and 22 GBD regions. Results: In 2019, a total of 294,422 new cases of ovarian cancer were reported. The highest age-standardized incidence rate (ASIR) was reported in areas with higher SDI, World high-income countries, continental Europe, and then America. In GBD regions, the highest age-standardized incidence is in Central Europe. In 2019, a total of 198,412 deaths due to ovarian cancer were reported. The highest ASR death is related to countries with high SDI and the World Bank high-income countries. In 2019, adjusted years of life with disabilities (DALYs) due to ovarian cancer were reported to be 5,359,737, of which 5,205,660 were related to lost years of life (YLLs), and 154,077 were related to years of life with disabilities (YLDs). Conclusions: In 2019, the highest age-standardized incidence of ovarian cancer, ASR death, and DALYs ASR belong to the high SDI countries. Designing interventions based on risk factors as well as providing preventive approaches to reduce the risk of this cancer, improving the treatment of ovarian cancer, and using appropriate and invasive treatments are recommended.

The Global Incidence, Mortality, and Burden of Breast Cancer in 2019: Correlation With Smoking, Drinking, and Drug Use.

Background: Female breast cancer (FBC) is the most common type of cancer and is associated with a considerable disease burden as well as significant mortality rates. The present study aimed to provide an update on the incidence, mortality, and burden of FBC in 2019, based on the Global Burden of Disease (GBD) Study. Materials: The incidence, death rate, disability-adjusted life years (DALYs), years of life lost (YLLs), years lived with disability (YLDs), the age-standardized rates (ASR) of FBC in 204 countries, and a variety of classifications, were retrieved from the Global Burden of Disease Study. Data on tobacco use, alcohol consumption, and drug use were collected. The incidence, mortality, and burden of FBC were registered and compared between regions. Associations between age-standardized incidence rates and age-standardized mortality rates of FBC with smoking, drinking, and drug use were determined. Results: The highest incidence of FBC was observed in countries with a high socioeconomic status such as those of the European continent. Despite the lower incidence of FBC in countries with a low socio-demographic index (SDI), mortality rates secondary to FBC are higher in these countries than in high-income countries. The highest age-standardized mortality rate has been reported in the Eastern Mediterranean Region (EMRO), followed by the African Region (AFRO). The highest age-standardized rates of DALY and YLL per 100,000 population in 2019 were observed in lower-income countries, while the highest ASR of YLD per 100,000 population was reported in high-income countries. Conclusion: The present GBD-based study provides a comprehensive review of the incidence, mortality, and burden of FBC in 2019. The incidence of FBC is higher in regions with a higher socioeconomic status, whereas mortality rates and DALYs are higher in poorly developed regions. We suggest better screening measures and early detection programs for the latter regions.

Impact of the COVID-19 Pandemic on Colorectal Cancer Screening: a Systematic Review.

BACKGROUND: After the World Health Organization (WHO) announcing about global pandemic of COVID-19 in March 2020 and relocation of health care resources for controlling this infection, cancer screening programs especially colorectal cancer (CRC) have been suspended in many countries. According to GLOBOCAN 2020 data, CRC is the third prevalent and second deadliest cancer in the world. So, early detection through screening is essential to reduce the mortality associated with this cancer. The present study was designed to investigate the impact of COVID-19 pandemic on colorectal cancer screening. METHODS AND MATERIALS: A comprehensive search performed on June 2021 in various databases, including Medline, Web of Science, and Scopus. Keywords such as "Early Detection," "Cancer," "Cancer Screening," "Cancer Screening Tests," "Coronavirus Disease-19," "COVID 19," "Coronavirus Disease," "SARS-CoV-2 Infection," "SARS-CoV-2," "2019-nCoV," "coronavirus, 2019 Novel," "SARS COV 2 Virus," "Severe Acute Respiratory Syndrome Coronavirus 2," "COVID-19," "COVID-19, Coronavirus Disease 19," "SARS Coronavirus 2","Colorectal neoplasm" and "Colorectal Cancer" were used individually or in combination to search. All articles were entered into Endnote X7 software that remove duplicates. Then, studies were first selected by title and then by abstract and at the end full texts were investigated. RESULTS: Of the 850 identified studies, 25 were identified as eligible. The results of studies show that in general, colorectal cancer screening has decreased from 28 to 100% in different countries and at different times after the onset of the COVID-19 pandemic. During this period, only 2 to 2.5% of hospitals and screening centers with 100% capacity continued to operate, and more than 77% of them limited their activities to less than 10% of their normal capacity. Also, completion of colonoscopies requiring examination showed a decrease of 65.7%, surveillance colonoscopy showed a decrease of 44.6 to 79%, prescription colonoscopy decreased 60 to 81%, and referrals to colonoscopy showed a 43% decline. However, emergency colonoscopy shows a 2 to 9% increase. The use of the Fecal immunochemical test (FIT) test is also generally declining but is increasing in areas used as a colonoscopy alternative. CONCLUSIONS: Considering that the reduction in colorectal cancer screening following COVID-19 pandemic is due to the restrictions imposed for the high prevalence of COVID-19 disease and the lack of referrals due to the fear of developing COVID-19 infection; compensating for the decline and preventing the continuation of this decreasing trend requires serious and effective interventions to maintain the capacity of screening services during the COVID-19 crisis, increase the capacity of screening centers during the lifting of restrictions and reduce fear in the public.

The effects of psychological counseling and acupressure based on couple therapy procedure for alleviation of vomiting and nausea in pregnant women in Iran country.

OBJECTIVES: Nausea and vomiting have psychological negative effects on some pregnant women during gestation. Different strategies have been used for the treatment of nausea and vomiting during pregnancy, such as acupressure and psychological interventions. This study was conducted to evaluate the effects of psychological counseling and acupressure based on couple therapy procedures on vomiting and nausea in pregnant women in Iran. METHODS: Two hundred and eight women were divided into four groups (n=52): 1) they did not any intervention (control group), 2) they received the psychological intervention, 3) they received acupressure intervention, and 4) they received a combination of psychological + acupressure interventions. To investigate the effects of interventions on nausea and vomiting, the Rhodes index of nausea, vomiting and retching were used. The counseling period has lasted for 4 weeks. The pressure intervention on the site was conducted in clockwise form for 1 min and anticlockwise form for another 1 min. RESULTS: Groups did not have a significant difference for abortion and income (p>0.05). The effects of counseling, and acupressure interventions on severity and period of vomiting and nausea were not significant (p>0.05), but the intervention based on counseling and acupressure decreased severity of vomiting and nausea (p<0.05). CONCLUSIONS: The intervention based on counseling and acupressure could not reduce nausea and vomiting during the gestation, but the intervention based on a combination of both decreased nausea and vomiting. It can be suggested to apply an intervention based on a combination of counseling and acupressure in short-time period for decreasing nausea and vomiting in women during pregnancy.

A review of barriers and facilitators to mammography in Asian women.

AIM: Breast cancer is the most common cancer among women in Asia and one of the major health problems in most countries in the region. Despite extensive advances in treatment, early diagnosis is one of the main methods for increasing the survival rate. It is necessary to evaluate the barriers and facilitators of screening in different societies. This study was conducted to identify the barriers and facilitators of mammography in Asia. MATERIALS AND METHODS: To identify the barriers and facilitators of mammography in Asia, a comprehensive search was carried out in databases such as Medline, Web of Science Core Collection and Scopus using keywords, including breast cancer, screening, mammography, barriers, facilitators and the names of each Asian country, as well as a combination of these keywords were used to help the search. Full-text, English language and original articles were included in this study. RESULTS: In total, 71 articles were entered into the study. The findings of this study revealed various barriers to mammography in Asian women, including knowledge, sociodemographic factors, cost and insurance, cultural factors, belief, attitude and feeling, fear, pain and embarrassment, self-efficacy, religious, psychological factors, time constraint, fatalism, professional recommendations, communication, social support and access. Also, knowledge, attitude and belief, perceived risk, professional and social factors were found to be facilitators of mammography. CONCLUSION: Knowing the barriers and facilitators to access mammography is the first step in the development of a successful screening program. Awareness and various personal, professional and social factors have emerged as the major barriers to access to mammography in most Asian countries.

Development and psychometric properties of maternal health literacy inventory in pregnancy.

BACKGROUND: Pregnancy is one of the most sensitive and important stages of women's life. Maternal health literacy is the key to achieving a healthy pregnancy. It also affects pregnancy outcomes by improving the quality of health care in this period. The aim of this study was to develop and evaluate the psychometric properties of maternal health literacy inventory in pregnancy (MHELIP). METHODS: This sequential, exploratory and mixed study was carried out in two parts (qualitative study and psychometric evaluation of the tool) in Tehran in 2016-18. The first part involved a qualitative content analysis with a traditional approach using in-depth, semi-structured and personal interviews with 19 eligible pregnant women. Then, the pool of items extracted from the qualitative part was completed by reviewing the existing literature and tools. In the second part, the overlapping items were summarized and the tool was validated. In order to evaluate the construct validity, a cross-sectional study was conducted with the participation of 320 pregnant women. Data analysis was performed by SPSS-19 software using exploratory factor analysis and reliability tests (Cronbach's alpha and ICC). RESULTS: Findings of qualitative part produced a pool of 120 items that reached to 124 items after reviewing the literature. After confirming face and content validity by calculating CVI and CVR for each item, 53 items remained in the pool. Finally, the results of exploratory factor analysis confirmed a tool with 48 items in four factors, explaining 46.49% of the variance of total variables of the tool. Reliability of the tool was approved by Cronbach's alpha = 0.94 and test-retest with 2-weeks intervals, indicating an appropriate stability for the scale (ICC = 0.96). Finally, the tool was finalized with 48 items in 4 dimensions, including "Maternal Health Knowledge", "Maternal Health Information Search", "Maternal Health Information Assessment" and "Maternal Health Decision Making and Behavior". CONCLUSION: The designed tool is a multidimensional, reliable and validated scale for assessing maternal health literacy during pregnancy. This tool can be used to evaluate different aspects of maternal health literacy in pregnant women, which was prepared based on their experiences during a qualitative study.

Relationship between dental plaque formation and salivary cortisol level in pregnant women.

PURPOSE: Understanding how increased level of salivary cortisol contributes to the development of dental biofilm during pregnancy can help inthe prevention of dental caries and periodontal diseases. This study aims to evaluate the relationship between salivary cortisol level and dental biofilm formation in pregnant women. PATIENTS AND METHODS: This descriptive-analytic study was conducted in Hamadan, Iran in 2011. Forty consecutive pregnant women with no history of abortion, stillbirth, or any known physical or psychological disorders at weeks 25 and 33 of gestation were included. Salivary samples were collected for measurement of cortisol levels by Enzyme Linked Immunoabsorbent Assay (ELISA) method. The amount and extension of dental biofilms were determined by using a disclosing agent. Data were analyzed using descriptive and analytical statistics in SPSS version 16. RESULTS: The mean levels of salivary cortisol at weeks 25 and 33 of gestation were respectively, 2.45 ± 1.56 µg/dl and 5.24 ± 4.07 µg/dl which demonstrates a significant difference (P<0.001). Evaluation of dental biofilm at two time intervals revealed a significant increase in amount of dental biofilm at week 33 of gestational period (34.65 ± 10.9% vs. 42.45 ± 12.35%, P<0.001). Elevated levels of dental biofilm were significantly correlated with salivary cortisol levels at week 33 (r=0.494, P=0.001),however, it was not significant at week 25 of gestation (r=0.148, P=0.361). CONCLUSION: The findings suggested that increased levels of salivary cortisol can predict dental biofilm formation and accumulation in pregnant women in the last weeks of gestation.

Do the Fertility Drugs Increase the Risk of Cancer? A Review Study.

Aim: All over the world, many couples cannot conceive a child and have problems with pregnancy. Ovulation-inducing drugs are among the most important drugs used for the treatment of infertility. In recent years, there have been many debates about the relationship between fertility medication and cancer. Due to the lack of comprehensive study of this matter, and as understanding the relationship between the use of fertility drugs and cancer is of importance, the present study was conducted to investigate the relationship between infertility drugs and cancer in women. Materials and Methods: To determine the relationship between infertility treatment and cancer, a comprehensive search was carried out in databases such as; Medline, Web of Science Core Collection, and Scopus using keywords words; "infertility," "ovulation induction," "cancer," "infertility treatment," "ART," "tumor," "controlled ovarian stimulation," "fertility agents," and "neoplasms." Full-text, English language, and original articles were included in this study. Results: In total, 81 articles were entered into the study. The relationship between fertility medications and breast, ovary, endometrial, uterus, colon, thyroid, skin, cervical, and non-Hodgkin's lymphoma cancers were studied. Although the relationship between fertility medications and cancer is theoretically justifiable, most studies have shown that risk of cancer will not increase after fertility treatment. Conclusion: The results of this study did not show that fertility medications increase the risk of cancer among users. In summary, the relationship between infertility treatment and cancer incidence remains an open question.

Ovarian cancer in the world: epidemiology and risk factors.

Aim: Ovarian cancer is one of the most common gynecologic cancers that has the highest mortality rate. Considering the fact that knowledge on the incidence, mortality of ovarian cancer, as well as its risk factors is necessary for planning and preventing complications, this study was conducted with the aim of examining the epidemiology and risk factors of ovarian cancer in the world. Materials and methods: In order to access the articles, Medline, Web of Science Core Collection, and Scopus databases were searched from their start to the year 2018. Full-text, English observational studies that referred to various aspects of ovarian cancer were included in the study. Results: In total, 125 articles that had been published during the years 1925-2018 were entered into the study. Ovarian cancer is the seventh most common cancer among women. Increased risk factors of cancer have led to an upward trend in the incidence of cancer around the world. In 2018, 4.4% of entire cancer-related mortality among women was attributed to ovarian cancer. Although the incidence of cancer is higher among high Human Development Index (HDI) countries, the trend of mortality rate tends to be reversing. Various factors affect the occurrence of ovarian cancer, from which genetic factor are among the most important ones. Pregnancy, lactation, and oral contraceptive pills play a role in reducing the risk of this disease. Conclusion: This study provides significant evidence about ovarian cancer. Considering the heavy burden of ovarian cancer on women's health, preventive measures as well as health education and early detection in high risk groups of women are highly recommended. Although some risk factors cannot be changed, a focus on preventable risk factors may reduce the risk of ovarian cancer. More studies are needed to explore the role of unclear risk factors in ovarian cancer occurrence.