Fear of childbirth and its relationship with anxiety and depression among Iranian fathers: a descriptive study

INTRODUCTION

In addition to mothers, fathers may find the perinatal period difficult and complicated and experience a wide variety of emotions, such as fear, anxiety and depression. These emotional changes can adversely affect a father's relationships with his infant and wife. This descriptive study aims to investigate the fear of childbirth in fathers during pregnancy and explore its relationship with anxiety and depression.

METHODS

A total of 302 husbands of pregnant women participated in this descriptive study through the cluster random sampling method. The data collection tools were the sociodemographic and obstetric characteristics questionnaire, Paternal Fear of Childbirth Scale, Spielberger's State-Trait Anxiety Inventory and Edinburgh Postnatal Depression Scale.

RESULTS

The mean (±SD) of paternal fear of childbirth score was 48.39 (±14.10) within the possible 17-85 range. According to Pearson correlation test results, fear of childbirth had significant direct correlations with depression (P < 0.001; r = 0.47), state anxiety (P < 0.001; r = 0.60) and trait anxiety (P < 0.001; r = 0.51). The adjusted general linear model results indicated that an increase in fear of childbirth score significantly increased depression (β = 0.18; 95% CI: 0.13 to 0.22; P < 0.001), state anxiety (β = 0.45; 95% CI: 0.38 to 0.53; P < 0.001) and trait anxiety (β = 0.35; 95% CI: 0.27 to 0.42; P < 0.001) scores obtained from participants.

CONCLUSION

It is recommended to develop comprehensive programmes to screen fathers for fear of childbirth and any other psychological problems, such as depression and anxiety, to implement appropriate preventive and therapeutic interventions.

Identifying potential circulating miRNA biomarkers for the diagnosis and prediction of ovarian cancer using machine-learning approach: application of Boruta

Introduction

In gynecologic oncology, ovarian cancer is a great clinical challenge. Because of the lack of typical symptoms and effective biomarkers for noninvasive screening, most patients develop advanced-stage ovarian cancer by the time of diagnosis. MicroRNAs (miRNAs) are a type of non-coding RNA molecule that has been linked to human cancers. Specifying diagnostic biomarkers to determine non-cancer and cancer samples is difficult.

Methods

By using Boruta, a novel random forest-based feature selection in the machine-learning techniques, we aimed to identify biomarkers associated with ovarian cancer using cancerous and non-cancer samples from the Gene Expression Omnibus (GEO) database: GSE106817. In this study, we used two independent GEO data sets as external validation, including GSE113486 and GSE113740. We utilized five state-of-the-art machine-learning algorithms for classification: logistic regression, random forest, decision trees, artificial neural networks, and XGBoost.

Results

Four models discovered in GSE113486 had an AUC of 100%, three in GSE113740 with AUC of over 94%, and four in GSE113486 with AUC of over 94%. We identified 10 miRNAs to distinguish ovarian cancer cases from normal controls: hsa-miR-1290, hsa-miR-1233-5p, hsa-miR-1914-5p, hsa-miR-1469, hsa-miR-4675, hsa-miR-1228-5p, hsa-miR-3184-5p, hsa-miR-6784-5p, hsa-miR-6800-5p, and hsa-miR-5100. Our findings suggest that miRNAs could be used as possible biomarkers for ovarian cancer screening, for possible intervention.

The Relationship of Childbirth Experience with Mother-Infant Bonding and Child's Growth and Development

Introduction: The negative experience of childbirth has many consequences for the mother and the baby. This study analyzed the relationship of childbirth experience with mother-infant bonding and the child's growth and development. Materials and Methods: In this cross-sectional study, the participants were 216 eligible women selected from all health centers in Zanjan City, Iran (36 health centers), using the census method. Data collection tools were as follows: childbirth experience questionnaire 2.0, postpartum bonding questionnaire, anthropometric indices checklist, and developmental age and stages questionnaire. The Pearson correlation test was used to determine the relationship of variables in univariate analysis, and a general linear model was used in the multivariate analysis. Results: The mean ± SD of the participants was 29.0 ± 5.7 years. Less than half of the studied women (40.3%) had a diploma, and most wanted pregnancy (94.9%). The mean ± SD scores of the childbirth experience and postpartum bondings were 2.6 ± 0.5 (score range: 1-4) and 6.6 ± 2.7 (score range: 0-125), respectively. Regarding child development, the highest mean score was in the domain of problem-solving (56.8 ± 5.7), and the lowest was in the domain of communication (50.1 ± 8.3). The results of the Pearson correlation test showed that the childbirth experience had a significant inverse correlation with the mother-infant bonding (r = -0.23, P = 0.001) and a significant direct correlation with fine motions (r = 0.18, P = 0.007). The results of the general linear model after adjusting the socio-demographic and obstetrics characteristics showed that the postpartum bonding score was lower in women with a more positive childbirth experience, which was also an indication of a better bonding (B= -2.92, 95% CI; -4.85 to -0.98, P = 0.003). Besides, the fine motor score was higher in women with a positive childbirth experience (B= 3.11, 95% CI: 0.733-5.487, P = 0.011). Conclusion: Considering the correlation between the variables of childbirth experience and mother-infant bonding and child development in the domain of ​​fine motor, health providers must do their best to create positive childbirth experiences for the women to improve the mother-infant bonding and child development domains.

The Effect of B-Cell Lymphoma 2 and BCL2-Associated X Polymorphisms on the Survival of Acute Lymphoblastic Leukemia Patients: Application of Frailty Survival Models

Background:

B-cell lymphoma 2 (BCL-2) and BCL-2 associated X (BAX) polymorphisms are important in the apoptosis process, response to treatment and survival in Acute Lymphoblastic Leukemia (ALL) patients. We aimed to investigate the effect of these genes with other predictors corresponding to the survival of ALL patients with an appropriate frailty survival model.

Methods:

Our study was performed in 2020 on sixty-two cases of childhood aged 3–16 (year) with ALL disease who were selected by convenience sampling from the two hospitals of Tabriz, Iran. RFLPPCR method was used for genotyping the promoter region of the BAX and BCL-2 genes. We used different frailty survival models, to control heterogeneity between individuals due to unmeasured factors affecting their survival. All analyses were implemented using Stata 16.

Results:

Based on the result of log-logistic model along with frailty gamma, the proportional odds (standard error) of survival for a CC allele of BCL-2 patient compared to a AA allele patient were 6.0 (1.47); P<0.001 and for a AC of BCL-2 allele patient were 0.57 (1.23); P=0.009. Patients with AG allele of BAX had 2.05 (1.26) times greater odds of surviving than a AA allele patient (P=0.003). The odds of survival of patients with abnormal white blood cell (WBC) were 92% less than normal WBC (P<0.001).

Conclusion:

With controlling unmeasured factors affecting, the BCL-2 and BAX genes promoter polymorphism are effective in the survival rates for ALL.

Effect of acceptance and commitment therapy on mood, sleep quality and quality of life in menopausal women: a randomized controlled trial

BACKGROUND

One of the most critical periods in a woman's life is menopause. During menopause, depression and anxiety are among the most common mood changes. Sleep disorders also increase during menopause, which leads to quality of life disorders. Different methods such as medication, psychotherapy, or a combination of them are used to treat these disorders. Acceptance and commitment-based therapy is one of the newest methods in psychotherapy that recently has been used a lot. Therefore, this study was conducted to determine the effect of acceptance and commitment therapy (ACT) on mood (primary outcome), sleep quality, and quality of life (secondary outcomes) of menopausal women.

METHODS

This randomized controlled trial was performed on 86 menopausal women in Tabriz, Iran in 2021. Using the blocking method, participants were randomly assigned into the intervention and control groups. The intervention group received counseling based on ACT approach in 8 sessions of 60 to 90 min. The control group received only routine health care. Depression, Anxiety, Stress Scale-21 (DASS 21), Menopause Quality of Life (MENQOL), and Pittsburgh Sleep Quality Index (PSQI) questionnaires were completed before intervention and immediately after the intervention. Independent t-test and Mann-Whitney U test were used to compare the outcomes between the two groups.

RESULTS

In terms of sociodemographic characteristics and baseline values of the studied variables, there was no statistically significant difference between the study groups before the intervention. At the end of the intervention, the mean (SD: standard deviation) scores of anxiety, stress, and depression in the counseling group were 2.66 (1.28), 2.91 (1.62), and 1.98 (1.59) and in the control group were 4.19 (1.85), 5.61 (1.49) and 3.59 (1.91). In the intervention group, the mean score of all three variables was significantly lower than the control group (P < 0.001). After the intervention, the mean (SD) of the total sleep quality score was 4.04 (2.52) in the counseling group and 4.13 (2.63) in the control group. In addition, the mean (SD) of the total quality of life score was 23.47 (20.13) in the counseling group and 23.14 (17.76) in the control group. Between the study groups, there were no statistically significant differences in the mean of the overall score of sleep quality (P = 0.867) and the overall score of quality of life (P = 0.759).

CONCLUSION

Using ACT-based counseling can improve the mood of menopausal women. However, further randomized clinical trials are needed before making a definitive conclusions.

TRIAL REGISTRATION

Iranian Registry of Clinical Trials (IRCT): IRCT20120718010324N65. Date of registration: 2/19/2021. Date of first registration: 2/19/2021. URL: https://en.irct.ir/user/trial/53544/view; Date of recruitment start date: 2/22/2021.

The effect of counseling on fathers' stress and anxiety during pregnancy: a randomized controlled clinical trial

BACKGROUND

Pregnancy is a challenging period for mothers and fathers. This study aimed to investigate the effect of counseling on stress and anxiety levels of fathers.

METHODS

This randomized controlled trial was conducted on 102 spouses of pregnant women in Ardabil, Iran. The participants were randomly assigned to intervention and control groups. The intervention group attended four 60-min counseling sessions at weekly intervals. The perceived stress and anxiety questionnaires were completed before and 4 weeks after the intervention.

RESULTS

The mean scores of state anxiety in the intervention group decreased significantly 4 weeks after the intervention compared with the control group (MD: -2.4; 95%CI: - 4.7 to - 0.2; p = 0.030). Four weeks after the intervention, no significant difference was found between the two groups in terms of trait anxiety (p = 0.472) and perceived stress (p = 0.635).

CONCLUSIONS

The findings indicate that counseling reduced state anxiety in expectant fathers; therefore, this intervention is recommended to be used to reduce fathers' anxiety.

TRIAL REGISTRATION

IRCT2017042910324N38 . Registered 25 June 2017.

Predictors of preventive behaviors of AIDS/HIV based on Health Belief Model constructs in women with high-risk sexual behaviors: A cross-sectional survey

BACKGROUND

Worldwide, AIDS is an acute problem. Health Belief Model (HBM) is a model for prevention and control of diseases. This study examined the predictors of preventive behaviors of HIV/AIDS based on HBM constructs in participants.

MATERIALS AND METHODS

This cross-sectional study was performed on 200 women who were referred to vulnerable women's centers across Tabriz city between November and December 2018. Participants were selected by census sampling. Inclusion criteria were having a health record, multiple sexual partners, reading and writing skills, and willingness to participate in the study. To collect data, questionnaires of sociodemographic characteristics, HIV knowledge, self-efficacy for negotiating safe sex, perceived sensitivity, perceived severity, perceived benefits, perceived barriers, and behavioral prevention (BP) were used. The collected data were analyzed using SPSS version 19 through Pearson's correlation coefficient, one-way ANOVA, and multiple linear regression analyses. The significant level was set at α = 0.05.

RESULTS

Pearson's correlation test showed a statistically significant correlation between BP and perceived sensitivity (r = 0.25), perceived benefits (r = 0.32), self-efficacy (r = 0.33), and HIV knowledge (r = 0.25) constructs (P < 0.001). According to the multiple linear regression, perceived sensitivity (P = 0.020), perceived benefits (P = 0.036), and some of the sociodemographic characteristics were found to be predictors of preventive behaviors that explained in total 50% of variance of BP (P < 0.05 and R ² = 0.504).

CONCLUSION

It seems that the HBM is useful to predict HIV preventive behaviors among this vulnerable group. Training programs should be aimed on improving the health belief of HIV preventive behaviors.

The effect of counseling based on ex-PLISSIT model on sexual function and marital satisfaction of postpartum women: A randomized controlled clinical trial

INTRODUCTION

Since routine counseling does not suffice to resolve the sexual problems at postpartum period, the present study aimed to investigate the effect of counseling based on the Ex-PLISSIT model on sexual function and marital satisfaction of postpartum women.

METHODS

This was a randomized controlled clinical trial that was conducted on 68 postpartum women (within 3-6 months after childbirth) who obtained a score <28 on the Female Sexual Function Index (FSFI). The participants were randomly assigned to the intervention and control groups. Participants in the intervention group received counseling based on the Ex-PLISSIT model and those in the control group received the routine postpartum care. The required data were collected using a demographics form, the FSFI, and the ENRICH Marital Satisfaction Scale. The primary outcomes were the mean function and martial satisfaction score of participants 4 and 8 weeks after the intervention.

RESULTS

There was no statistically significant difference between the two groups in terms of sexual function at baseline (P = 0.381), but it was significantly higher in the intervention group than control group after intervention (the adjusted MD: 4.24, 95% confidence interval [CI]: 3.18-5.29, P < 0.001). There was no statistically significant difference between the two groups in marital satisfaction before the intervention (P = 0.433), but it increased significantly in the intervention group in comparison to control after intervention (adjusted MD: 23.17, 95% CI: 15.10-31.24, P < 0.001).

CONCLUSIONS

The study findings suggested that sexual counseling based on the Ex-PLISSIT model can improve the sexual function and increase marital satisfaction of postpartum women.

The effect of counseling based on acceptance and commitment therapy on mental health and quality of life among infertile couples: A randomized controlled trial

INTRODUCTION

Infertility by creating a disturbing and debilitating condition is considered as an important individual, public, and social health problem. The purpose of this study was to determine the effect of counseling based on acceptance and commitment therapy (ACT) on mental health and quality of life in infertile couples.

METHODS

In this randomized controlled trial, 54 infertile couples referring to the Sanandaj-Iran Infertility Clinic were assigned into two groups of counseling and control by random blocking with a 1:1 ratio. The consulting group received 8 weekly 90-min sessions of group counseling based on ACT. The General Health Questionnaire-28 (GHQ-28) and Fertility Quality of Life were completed before and 1 month after the completion of the intervention. Primary outcome measures were mean score of mental health and quality of fertility life. Independent t-test, ANCOVA, and Mann-Whitney U-test were used to analyze data.

RESULTS

There was no significant intergroup difference in demographic information (P > 0.05). One month after the end of the intervention, the mean overall mental health score in the couples of the counseling group was significantly less than the control group (adjusted mean difference [aMD]: -8.4; 95% confidence interval [CI]: -10.4--6.4; P < 0.001). Furthermore, the mean overall score of quality of life in the counseling group couples was significantly more than the control group (aMD: 14.8; 95% CI: 11.8-17.9; P < 0.001).

CONCLUSION

Based on the effectiveness of counseling based on ACT on mental health and quality of life in infertile couples, it can be used in the infertility clinics. Health-care providers and counselors should train in the ACT courses to improve the mental health and quality of life of infertile couples.

Pre-natal and post-natal anxiety in relation to pre-pregnancy obesity: A cohort study on Iranian pregnant women

Background:

To determine the association between pre-conception obesity and screening results of pre-natal and post-natal anxiety in women that referred to the health centers of Tabriz, Iran.

Methods:

62 obese (class 2-3) and 245 normal-weight women were enrolled in the first trimester of pregnancy through the cohort study and followed-up 1 year after childbirth from December 2012 to January 2016. The Beck anxiety inventory scale (BAI-II) was completed in five time points: the first, second, third trimester of pregnancy, 6–8 weeks and 12 months after childbirth. Chi-square, Fisher’s exact tests, Independent t-test, Mann-Whitney, and multivariate logistic regression adjusted for confounders were used for data analysis. Statistically significant was considered as p<0.05.

Results:

The rate of moderate to severe anxiety in 1^st, 2^nd, 3^rd trimesters of gestation, 6–8 weeks and 12 months after birth was 8.6%, 10%, 12.6%, 7.8%, 6.5% in normal weight women versus 18%, 17.9%, 19.2%, 12.5%, 19.4% in obese class II women, respectively. The odds of anxiety in the first trimester of pregnancy for class 2–3 obesity was 2.72-fold greater than normal weight group [adjusted odds ratio (aOR) 2.72, 95% confidence interval (CI) 1.14–6.47; p=0.023]. This odd was 3.30- fold (aOR 3.30, 95%CI 1.13-9.60; p=0.045) for 1 year after birth.

Conclusion:

Obesity remained associated with positive screening for anxiety in the first trimester of pregnancy and one year after birth. Obese women more likely require special medical care during their pregnancy due to its impacts on mood.

Effect of counselling with men on perceived stress and social support of their pregnant wives

BACKGROUND

Given the important role of spouses during pregnancy, this study aimed to determine the effect of counseling with men on stress and social support of their women (primary outcomes), anxiety, depression, weight gain, newborns' anthropometric indicators, frequency of cesarean section and preterm delivery (secondary outcomes).

METHODS

102 pregnant women were randomly assigned to two groups of counseling and control. Four sessions of counseling were held for the spouses of intervention group. Perceived Personal Resource Questionnaire-85-Part2, Perceived Stress Scale, Edinburgh's Postpartum Depression Scale, and Spielberger's State and Trait Anxiety Inventory were completed before and four weeks after intervention. The participants were followed up until delivery, and newborns' anthropometric indicators, delivery type, and preterm delivery were recorded.

RESULTS

The mean score of social support increased significantly 4 weeks after intervention in the counseling group compared to the control group (MD:12.7; 95%CI: 18.5 to 6.9). There was no significant difference between groups in the mean score of stress, anxiety, depression, and weight gain during pregnancy at four weeks after intervention and also frequency of cesarean delivery, preterm delivery, and anthropometric indicators of newborns (p>0.05).

CONCLUSIONS

Counseling with fathers can be recommended as an effective intervention to increase social support of pregnant women.

TRIAL REGISTRATION

IRCT2017042910324N38. Registered 25 June 2017, http://en.irct.ir/trial/10813.

The effect of the supportive program on the anxiety of mothers of infants with gastrointestinal anomalies

Background & Aim: The birth of an abnormal infant and his admission to the intensive care unit creates various mental health effects on their mothers and increases their anxiety. The goal of this study was to determine the effect of supportive programs on the anxiety of mothers of infants with gastrointestinal anomalies. Methods & Materials: This randomized controlled clinical trial was conducted in the Neonatal Intensive Care Unit in Tabriz, Iran. In this study, 50 mothers who had infants with gastrointestinal anomalies were assigned randomly to control and intervention groups. The control group received routine care, and the intervention group received special supportive care: emotional, informational, self-esteem, and caring support during four sessions for a 45-minute duration. Maternal anxiety was measured using the State-Trait Anxiety Inventory. Data were analyzed by using SPSS/19 and paired-sample and independent t-test. Results: The results showed that both groups of mothers had high-level anxiety in the pre-test. In the post-test, the mothers' anxiety level in the intervention group was significantly lower than the control group. ANCOVA test to compare the mean difference of state and trait anxiety in both groups showed that these changes were statistically significant (P<0.001). Conclusion:  This study tried to introduce a protocol to protect mothers of gastrointestinal anomalies, which could be used in the Neonatal Intensive Care Unit. The findings of this study also highlighted the importance of supporting one of the fundamental principles of family-centered care. Based on the outcomes of this research, emotional, informational, self-esteem, and caring support could reduce the mother’s anxiety.

Effect of counselling on health-promoting lifestyle and the quality of life in Iranian middle-aged women: a randomised controlled clinical trial

BACKGROUND

Promotion of healthy lifestyle is an important strategy. This study was conducted to determine the effects of counselling on health-promoting lifestyle and quality of life in middle-aged women.

METHODS

This randomised, controlled, clinical trial was conducted on 102 middle-aged women presenting to health centers in Tabriz, Iran, in 2016-17. Using stratified blocking based on age (40-50 and 50-60 age groups) with block sizes of four and six, eligible middle-aged women were randomly allocated to the intervention and control groups. The intervention group received health-promoting lifestyle counselling over three 45-min sessions. The control group received the routine care provided by health centers. The Health Promoting Lifestyle Profile- II (HPLP-II) and quality of life survey (SF-36) were completed in both group before and four and eight weeks after completion of the intervention. Data were analyzed using the independent t-test and the repeated measures analysis of variance (ANOVA).

RESULTS

After adjustment for the baseline values, the repeated measures ANOVA showed that the mean scores of health-promoting lifestyle (adjusted mean difference = 0.91, 95% confidence interval: 0.83 to 0.99, P < 0.001) and quality of life (18.2, 15.75 to 20.66, P < 0.001) were significantly higher in the intervention compared to the control group after the intervention.

CONCLUSION

Counselling can improve health-promoting lifestyle and quality of life in middle-aged women.

TRIAL REGISTRATION

IRCT2015122610324N27. Registered 4 February 2016.

The effect of educational text message based on health belief model on osteoporosis preventive behaviors in women: a randomized controlled clinical trial

The purpose of this study was to investigate the effect of educational text messages, based on the health belief model, on osteoporosis preventive behaviors among women aged 30-45 years. This trial was conducted on 121 women from November until September 2017 in Shabestar, Iran. The intervention group received a daily educational text message about osteoporosis for one month, and the control group received educational text messages on frequently occurring cancers in women. Two months after the training, data were collected using the osteoporosis health belief scale, a food frequency questionnaire and the International Physical Activity Questionnaire. No significant differences were observed at baseline between the two groups, except for the perceived benefits construct. After the intervention, controlling for baseline score and adjusting for educational level, a statistically significant difference was observed between the two groups in HBM structures and nutrition performance, while no significant difference was observed in physical activity between the two groups. This study showed that educational text messages can be effective in increasing awareness, perceived susceptibility and severity, and nutritional behavior change related to risk of osteoporosis.

Breastfeeding performance in Iranian women

AIM

Studies have shown that breastfeeding has both short-term and long-term useful effects on mother's and newborn's health. This study was conducted with the aim of determining predictors of breastfeeding performance in women who were referred to health centres in Tabriz City, Iran, in 2014 to 2015.

METHODS

This cross-sectional study cluster-sampled 220 breastfeeding women with infants aged 4 to 6 months. The Breastfeeding Self-Efficacy Scale, the Iowa Infant Feeding Attitude Scale, the personal resource questionnaire-85, and a researcher-developed knowledge questionnaire were used to collect data. Multivariate linear regression model was used to determine predictors of breastfeeding performance.

RESULTS

The results showed that participants' breastfeeding performance mean (SD) value was 3.6 (1.2) of 6. There were significant relationships between breastfeeding performance and breastfeeding self-efficacy (P = .033) but not between social support, knowledge, attitudes, and breastfeeding performance (P > .05). Breastfeeding self-efficacy, occupation, family income sufficiency, and living with the family were identified as predictors of breastfeeding performance.

CONCLUSION

Given the relationship between breastfeeding self-efficacy and breastfeeding performance, strengthening mothers' self-efficacy should be considered, especially when compiling programs to promote breastfeeding. Increasing breastfeeding self-efficacy in women improves their breastfeeding performance: In developing programs to promote breastfeeding culture, women's self-efficacy should be considered.

Effect of olive oil massage on weight gain in preterm infants: A randomized controlled clinical trial

Background:

Despite the fact that effect of massage with or without oil on the baby's weight gain is not clear, but recent studies have shown that massage with essential oils make lipid absorption through the skin. The aim of this study was to evaluate the effect of olive oil massage on weight gain in preterm infants.

Materials and Methods:

This study was a single-blind, randomized controlled clinical trial. In this study, infants who met inclusion criteria for the study were divided into two groups by using random numbers table. Newborns in intervention group were under massage for 10 days and 3 times for 15 min daily; the mother of these newborns had been trained already using olive oil. Moreover, the infants of the control group were under massaging without oil same as the above-mentioned method. Researchers weighed babies daily during 10 days and recorded it at the checklist. Data from the study were reviewed and analyzed by descriptive statistics and repeated measure test using the statistical software SPSS/13.

Results:

This study showed that the neonatal weight gain in the infants with the oil massage was 21 g daily in average, whereas the increase in infant massage without oil was 7 g. This difference was statistically significant (P < 0.001).

Conclusion:

Considering the positive effect of infant massage on weight gain in premature infants with olive oil, it is recommended that nurses use oil in infant massage in the neonatal units.

Effect of aerobic exercise and nutrition educationon quality of life and early menopause symptoms:A randomized controlled trial

The aim of the authors in this randomized controlled study was to assess the effect of exercise and nutrition education on quality of life and early menopausal symptoms. This trial was conducted in east Azerbaijan Province, Iran, during the period from 2013 to 2014 with 108 women allocated into one of four groups (n = 27 in each group) by block randomization. The interventions received by the three intervention groups were: nutrition education, aerobic exercise, or exercise plus nutrition education. The control group did not receive any intervention. The Greene and MENQOL menopause symptom scales were completed before and at 8 and 12 weeks after the intervention. The mean Greene score was significantly lower than the control group in the exercise (adjusted mean difference: -5.1) and exercise plus nutrition groups (-8.0) at the end of week 8 and in the nutrition (-4.8), exercise (-8.7), and exercise plus nutrition (-13.2) groups at the end of week 12. Also, the mean MENQOL score was significantly lower than the control group in the exercise (-8.3) and exercise plus nutrition groups (-13.8) at the end of week 8 and in the nutrition (-6.6), exercise (-13.5), and exercise plus nutrition (-22.1) groups at the end of week 12. Nutrition education with aerobic exercise can improve quality of life.

Sexual Dysfunction and Help Seeking Behaviors in Newly Married Men in Sari City: a Descriptive

INTRODUCTION

Sexual dysfunction is a major concern for people's general health. The aim of this study was to determine the status of sexual function and help-seeking behaviors in newly married men.

METHODS

This descriptive study was conducted on 363 newly married men. Simple random sampling was used according to premarital counseling offices in the health center of Sari city. Data collection instruments included personal and social characteristics, Arizona Sexual Experience Scale (ASEX), and help-seeking behaviors questionnaires. In order to determine the relationship between characteristics and sexual function, general linear model and also between socio-demographic characteristics and receiving or lack of receiving help, multivariate logistic regression test were used.

RESULTS

The mean of sexual function score was 21.3 (2.7) out of possible 5-30, and 26% of men suffered sexual dysfunction. The highest prevalence (27.2%) of dysfunction was in the dimension of sexual stimulation, and the lowest (15.7%) in maintaining erection. For the treatment of sexual dysfunction, only 32% men had sought help, and 40% of them had visited specialists. The most frequent reasons for not seeking help were feeling uncomfortable with doctor, and their belief that doctor is not able to do much. 65% of men desired to be treated.

CONCLUSION

The results demonstrated relatively high prevalence of sexual dysfunction among men, and unfortunately, most of them did not seek help for their sexual problem. Since Sexual dysfunction can leave damaging effects on the quality of life and marital relationship, interventions to deal with these challenges and screening to identify such problems appear necessary.

Comparing the results of Pap smear and Direct Visual Inspection (DVI) with 5% acetic acid in cervical cancer screening

Background:

Cervical cancer is the most second common cancer among Iranian women. This study was carried out to compare the results of Pap smear method and Direct Visual Inspection (DVI) with 5% acetic acid in cervical cancer screening in Tabriz, Iran.

Material and Methods:

This cross-sectional study was carried out in Alzahra Therapeutic-Educational Centre, Tabriz, Iran in 2013 on 1000 women. First, Pap smear was done for all women, and then the cervix exposed with 5% acetic acid by cotton swab for 30 seconds and observed under adequate light. At the end, women with abnormal results in Pap smear or DVI method were referred to colposcopy and biopsy. Test's sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), LR+, LR- and confidence interval (CI) were determined (P < 0.05).

Results:

Nine-hundred and seventy-four (94.7%) cases were normal and had no abnormal findings and 26 (2.6%) participants had positive results in Pap smear or DVI test. Twelve women had abnormal Pap smear (nine women with atypical squamous cells of undetermined significance, ASCUS, three women with dysplasia, atypical endocervical, and low-grade squamous intraepithelial lesion, LSIL results) and 14 women had positive DVI (four women with human papillomavirus, HPV or koilocyte,) and one women with abnormality in both method had carcinoma in biopsy that referred to oncologist. In this study the sensitivity, specificity, PPV and NPV for DVI were 71.4%, 50%, 35.7%, and 81.8% respectively in comparison with 14.3%, 50%, 10%, and 60% for Pap smear.

Conclusion:

As the DVI method has higher sensitivity and positive predictive value than Pap smear, it could be used as a useful method beside the Pap smear.

Association of the folic acid consumption and its serum levels with preeclampsia in pregnant women

BACKGROUND AND OBJECTIVES

Preeclampsia is one of the main causes of maternal and fetal mortality. Despite numerous studies, its etiology is unknown. Recently there has been attention towards Folic acid. This study examined the association of Folic acid consumption and its serum levels with Preeclampsia.

MATERIALS AND METHODS

A case-control study conducted in Tabriz- Alzahra hospital. 52 preeclamptic women in 34-42 weeks and 52 normotensive pregnant women were studied from Jun to Nov 2009. Data was gathered through interview with the women and review of their medical records. Folic acid serum levels were measured by electrochemiluminescence method on Elecsys-2010 system using the Roche brand kit. Data were analyzed by t-test, chi-square, exact fisher and logistic regression.

RESULTS

46% of women in the case group and 71% in the control group regularly consumed Folic acid supplements before and during the first trimester of pregnancy. Frequency of correct pattern of Folic acid consumption in the case group were significantly lower than control group (P = 0.02). Findings about frequency of main food groups' consumption containing folic acid indicated that the only mean difference between two groups was in relation to fruits (P = 0.002). The mean of Folic Acid serum levels in preeclamptic group was significantly lower than non- preeclamptic group [10.9 (3.9) vs. 13.6 (4.0) ng/ml, P = 0.001].

CONCLUSION

it is recommended all health care providers educate clients especially high risk women about regular and timely consumption of supplements as well as food groups containing Folic acid specially fruits and its possible role in prevention of preeclampsia.