Effect of Carob and Ginseng Supplements on Semen Analysis Parameters, Sexual Function, and Sex Hormones in Infertile Men: Double-Blind, Randomized Controlled Trial Study.

Background: Infertility is one of the most common problems in the world; there is a growing demand for herbal medicines to treat infertility-related problems. Materials and Methods: A randomized controlled trial with three groups was conducted, each with 30 participants. The first group was administered 1.5 grams of Carob daily, the second group was administered 1.5 grams of Ginseng daily, and the third group received a placebo. The treatment was administered for 12 weeks, and before and after the intervention, semen parameters, testosterone, prolactin, luteinizing hormone, follicle-stimulating hormone, thyroid hormones, and sexual function were evaluated. Sexual function was assessed using the International Index of Erectile Function Questionnaire. Results: The mean (SD) age of participants was 34.83 (6.22), 34.60 (5.78), and 33.67 (5.82) years in Carob, Ginseng, and Placebo groups, respectively. The results showed that in the Carob group, the normal volume of semen (Z 133 = 3.05, p = 0.02) and the normal shape of sperm (Z 134 = 2.97, p = 0.01) increased significantly compared to the control group. In the Ginseng group, the normal volume (Z 133 = 3.90, p = 0.001) and the normal viscosity of semen (Z 133 = 2.36, p = 0.01) increased significantly compared to the control group.The Carob group showed a significant increase in normal sperm counts and testosterone hormone levels (Z 131 = 2.81, p = 0.05). The Ginseng group demonstrated a significant improvement in orgasm function (H2 = 6.14, p = 0.04) and the total score of the International Index of Erectile Function (IIEF) (H2 = 5.8, p = 0.05). Conclusions: Carob supplements are suggested to enhance some semen parameters and male sex hormones. For infertile men, Ginseng can be beneficial in improving sexual function.

The effect of midwife-oriented breastfeeding counseling on self-efficacy and performance of adolescent mothers: a clinical trial study.

BACKGROUND: Breastfeeding behaviors are strongly influenced by self-efficacy. This research aimed to determine the effect of breastfeeding counseling based on the Ready Set Baby (RSB) education program on self-efficacy and breastfeeding performance in adolescent mothers. METHODS: In 2022, a parallel randomized clinical trial was carried out in Hamadan city's comprehensive health centers, involving 64 pregnant teenagers. The block randomization method was employed to divide the participants into two groups. The data collection instruments were a demographic characteristics questionnaire, a breastfeeding self-efficacy questionnaire, and the Bristol breastfeeding checklist. Three individual counseling sessions during pregnancy were conducted based on the "RSB" program. The ANCOVA was used for comparing groups. The statistical analyst was blinded to the group assignment. RESULTS: The study included 64 participants with a mean age of 16.97(1.30) years, data from 60 participants were analyzed. The demographic and clinical characteristics of the two groups were relatively similar (P > 0.05). Following the intervention, self-efficacy and breastfeeding performance scores were measured and adjusted for confounding factors. The mean scores for self-efficacy were 116.03(20.64) and 100.02(20.64) (P < 0.005), with effect size 0.77 [MD = 16.01 (95% CI: 5.34,26.67)], and the mean scores for breastfeeding performance were 6.30(2.07) and 4.12(2.07) (P < 0.002), with effect size 1.05 [MD = 2.18 (95% CI: 1.11,3.24)] in the intervention and control groups, respectively. CONCLUSIONS: The Ready Set Baby education program's breastfeeding counseling for primiparous adolescent pregnant women significantly boosted their self-efficacy and performance in breastfeeding. Given the crucial role of breastfeeding in ensuring the well-being of both mother and child, further research is imperative to identify suitable and impactful interventions that can encourage breastfeeding practices among adolescents. TRIAL REGISTRATION: The trial protocol of this study has been registered in Iranian Registry of Clinical Trials at 08/09/2021. The registration reference is IRCT20200530047596N3.

Effect of CoQ10 Supplement on Spermogram Parameters and Sexual Function of Infertile Men Referred to The Infertility Center of Fatemieh Hospital, Hamadan, Iran, 2019: A Randomized Controlled Trial Study.

BACKGROUND: The aim of this study was to investigate the effects of the antioxidant supplement of CoQ10 and placebo in the male infertility treatment. MATERIALS AND METHODS: The randomized controlled trial study was designed as a clinical trial. Samples in each group consisted of 30 members. The first group received 1 daily dose of 100 mg coenzyme Q10 capsules and the second group received a placebo treatment. Treatment in both groups lasted 12 weeks. Before and after the intervention of semen analysis, hormonal measurement of testosterone, prolactin, luteinizing hormone (LH), follicle-stimulating hormone (FSH) and thyroid stimulating hormone (TSH) were done. Sexual function was assessed before and after the intervention by using the International Index of Erectile Dysfunction questionnare. RESULTS: The mean age of participants was 34.07 (5.26) years in the CoQ10 group and 34.83 (6.22) in the placebo one. Normal volume of semen (P=0.10), viscosity (P=0.55), sperm count (P=0.28), and sperm motility (P=0.33) in the CoQ10 group increased without statistically significant differences. But the normal sperm morphology increased with statistically significant differences in the CoQ10 group (P=0.01). There was an increase in normal FSH levels and testosterone levels in the CoQ10 group compared with the placebo patients, but these differences were not statistically significant (respectively P=0.58, P=0.61). The results also revealed that the scores of erectile function (P=0.95), orgasm (P=0.86), satisfaction with sexual intercourse (P=0.61), overall satisfaction (P=0.69) and the score of the International Index of Erectile Function (IIEF, P=0.82) were greater after the intervention in the CoQ10 group than in the placebo group although the difference was not statistically significant. CONCLUSION: The use of CoQ10 supplement can improve sperm morphology; however, in other sperm parameters and also in some hormones increased after the intervention, this was not statistically significant and therefore the result is not conclusive (registration number: IRCT20120215009014N322).

Effect of Carob Supplement on Spermogram Parameters and Sexual Function of Infertile Men Referred to the Infertility Center, Hamadan, Iran, 2019: A Randomized Controlled Trial.

Objective: The purpose of this study is comparison of carob with placebo in the treatment of male infertility. Materials and methods: This study was performed as a clinical trial with two-group pretest-posttest design. Each group consisted of 30 members. The first group received 1.5 grams of carob per day, and the second group received placebo treatments. Treatment lasted for 12 weeks. Semen analysis as well as testosterone, prolactin, (LH), (FSH) and (TSH) were performed before and after drug treatment in two groups. Sexual function was assessed in the groups in two stages before and after the intervention using the standard International Index of Erectile Function. P-value less than 0.05 was considered statistically significant. Statistical analysis of data was performed using SPSS 16. Results: The participants' mean age was 34.83 ±6.22 in the placebo and 33.67 ±5.82 years in the Carob group. The results showed in the carob group compared to the placebo group, the rate of normal sperm counts increased by 17% and also the normal level of testosterone was 40% higher than the abnormal levels of the placebo group and these differences were statistically significant (P <0.05). And in most areas of sexual function, the mean scores after the intervention were higher than before (P> 0.05). Conclusion: It is recommended to use carob supplements to improve spermogram parameters and male sex hormones.

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.

Investigating the effect of couple-centered counseling by Gottman method on the intimacy of infertile couples referring to the infertility Ward of Fatemieh hospital, Hamadan, Iran in 2020: a quasi-experimental study.

BACKGROUND: Infertility is among the most unpleasant experiences for couples struggling with it. Therefore, coping with its associated psychological burden has become a concern in many societies due to its negative impacts on couples' lives and intimacy levels. Lack of marital intimacy leads to unfortunate consequences such as dissatisfaction with marital relationships between spouses. Therefore, these people should be encouraged to find an effective solution to cope with infertility. Regarding the importance of the emotional relationship between infertile couples and the success rate of infertility treatment, this study aims to determine the effect of couple-centered counseling by the Gottman method on marital intimacy of infertile couples referred to the infertility ward of Fatemieh Hospital in Hamadan. METHOD: The sample of this quasi-experimental study included 60 infertile couples in the evaluation phase of treatment with primary infertility. We collected data in a referral infertility center in Hamadan (Iran) between December 2020 and May 2021. Marital intimacy was measured using Thompson & Walker's Marital Intimacy Questionnaire. At the beginning of the study, the intervention and control groups completed this questionnaire. The intervention group received Gottman couple-centered counseling based on GATHER principles in 8 sessions. The groups completed the questionnaires 4 weeks after the last intervention session again. If the distribution was normal, the ANCOVA test was used to evaluate the differences between the two groups. Intra-group comparisons were performed using paired t-test, and intergroup comparisons were performed using an independent t-test. RESULTS: The mean score of female intimacy increased significantly after the intervention (P = 0.009). There was no significant difference in socio-demographic characteristics between groups (P < 0.05), both of which were adjusted in ANCOVA. After the intervention, the mean marital intimacy scores were significantly higher in women participating in the intervention group (from 75.6 (±10.63) to 78.86 (±7.87)). In addition, after the ANCOVA test, the difference was statistically significant (P = 0.009; MD: 3.74, CI: 0.95 and 6.52). The mean score of male marital intimacy increased after the intervention (from 78.93 (±10.21) to 78.9 (±9.79)), although the difference was not statistically significant (P = 0.54; MD: -0.58, CI: - 2.51 and 1.34). CONCLUSION: The findings support the effective role of Gottman's couple-centered counseling in increasing marital intimacy by raising couples' awareness about the principles of proper relationships between them. This outcome suggests that counseling with couples, especially in critical life situations, can improve their relationship in the infertility treatment process and prevent emotional divorce and other negative impacts on their lives. TRIAL REGISTRATION: IRCT Registration Number IR.UMSHA.REC.1399.535, registered on 21/09/2020.

Effect of Evening Primrose Vaginal Capsule on Cervix Preparation and Duration of First Stage of Labor in Nulliparous Women Referred to Fatemieh Hospital in Hamadan, Iran: A Single-blind Randomized Controlled Trial.

BACKGROUND: Cervix preparation is one of the main steps in the onset of labor and is very important for success in initiating or inducing labor. OBJECTIVE: The present study aimed at investigating the effect of evening primrose vaginal capsule on the preparation of cervix and the consequences of labor in nulliparous women. METHODS: This randomized clinical trial study was conducted in 2018 on 100 nulliparous women referred to Fatemieh Hospital in Hamadan. In intervention group (50 people), one evening primrose capsule (500 mg) was used vaginally and then two hours later, another capsule was used, and placebo was used in the control group (50 people). Then, the dilatation, effacement, Bishop scores and duration of the first stage of the labor were compared in two groups after 4 hours. Statistical analysis was performed with SPSS 21. The significance level was considered to be 0.05. RESULTS: There was a statistically significant difference in the mean score and standard deviation of dilatation, effacement of cervix, bi-shop scores and duration of the first stage of labor four hours after the intervention in the intervention and Placebo groups by controlling the effect of potential confounding factors (P <0.001). CONCLUSION: The results showed that the use of evening primrose vaginal capsules can reduce the length of the first stage of labor, improve Bishop score, and soften and ripen the cervix.

Effect of Hysterectomy due to Benign Diseases on Female Sexual Function: A Systematic Review and Meta-analysis.

OBJECTIVE: Determination of the effect of hysterectomy caused by benign diseases on female sexual function. DATA SOURCES: A search was performed on Scopus, PubMed, Science Direct, ProQuest, ISI Web of Knowledge, and Embase databases. The keywords included hysterectomy (as exposure) and female sexual function (as outcome). Original English observational studies, including cohort, case-control, and cross-sectional studies published as of February 2021, which reported an association between any type of hysterectomy caused by benign female disease and sexual function as an outcome, were included in the study. Studies in participants who received hormone replacement therapy and had sex other than heterosexuals were not included. There was no limit to the initial search period, and articles published by February 2021 were searched. METHODS OF STUDY SELECTION: The search process resulted in the retrieval of 5587 potentially related articles. After removing duplicated studies, the title and abstract were reviewed and 77 articles remained with the removal of unrelated items. The full text of 14 articles was published in non-English languages, and 52 articles were removed because they did not meet the inclusion criteria, and finally, 11 articles were included in the final analysis. TABULATION, INTEGRATION, AND RESULTS: The Newcastle-Ottawa scale was used to assess the methodological quality of included studies. The evidence was synthesized using meta-analysis via random-effect model with the Der Simonian and Laird weighted method. Publication bias was assessed using the funnel plot and Begg's and Egger's tests. The pooled standardized mean difference for sexual function in hysterectomy vs nonhysterectomy group was 0.08 (95% confidence interval, -0.38 to 0.55; I2 = 96.8%; χ2 = 307.94; p <.001; τ2 = 0.59). Publication bias and small study effects were not detected. The results of the subgroup analysis showed that the possible sources of heterogeneity are the World Bank countries classification and type of hysterectomy (in some studies, the type of hysterectomy was not specified separately for the study groups; because of this, comparisons were made between Total and supracervical/total). Pooled standardized mean difference was affected by the type of sexual function scale, World Bank countries classification, type of hysterectomy, ovary status, and reproductive status. The results of meta-regression analysis also showed that for each month of distance from hysterectomy, women's sexual function score increases by 0.18. CONCLUSION: The results of this study showed that hysterectomy caused by benign diseases does not change the sexual function significantly.

Midwifery-oriented group counseling based on the GATHER approach on quality of life of women during the transition to menopause: a randomized controlled trial.

OBJECTIVE: This study aimed to determine the effect of midwifery-oriented group counseling based on the GATHER model on the quality of life of women during the transition to menopause. METHODS: This randomized controlled clinical trial was performed on 90 women 45 years or older in 2019 to 2020 in Kermanshah, Iran. The women were assigned into two groups using a randomized blocked design. In the intervention group, counseling sessions based on the GATHER approach (Greet, Ask, Tell, Help, Explain, and Return) were performed in four sessions of 45 to 90 minutes. Sociodemographic and quality of life (MENQOL) questionnaires were used for data gathering. Data were analyzed by Mann-Whitney test, sample t test, and Wilcoxon using SPSS 24. RESULTS: The mean age of women was 49.04 ±â€Š3.94 and 49.62 ±â€Š3.63 in the intervention and control group, respectively (P = 0.412). There was no significant difference between the two groups regarding demographic characteristics and quality of life before the intervention (P > 0.05). There was a considerable difference between the mean score of quality of life 55.62 ±â€Š18.37 and 73.64 ±â€Š25.84 (P = 0.001) and its dimensions, especially for physical symptoms (P = 0.002), between the two groups 4 weeks after the intervention. CONCLUSIONS: The results of this study suggest that midwifery-oriented group counseling based on the GATHER approach may improve the life quality of women during the transition to menopause.

Video Summary:http://links.lww.com/MENO/A816 .

The Effect of Evening Primrose Oil Capsule on Hot Flashes and Night Sweats in Postmenopausal Women: A Single-Blind Randomized Controlled Trial.

OBJECTIVES: Menopause is associated with complications that could decline women's health during this period. Therefore, some of its complications, such as hot flashes and night sweats, must be treated or alleviated. METHODS: This randomized controlled trial included postmenopausal women who were referred to health centers in Hamadan from May 2018 to April 2019. The hot flash and night sweat questionnaires were completed by the researcher a week before and 8 weeks after the intervention. The intervention group took one capsule (1,000 mg) of evening primrose oil twice daily, while the control group received the same amount of placebo. Finally, the results were analyzed using Stata 13. RESULTS: The mean scores of duration, frequency, and severity of hot flashes did not significantly decrease in both groups after the intervention compared with before the intervention, and no statistically significant difference was observed (P > 0.05). However, the intervention group had lower frequency and severity of night sweats after the intervention than the control group, with statistically significant differences (P < 0.05). CONCLUSION: Evening primrose oil effectively decreased the frequency and severity of night sweats.

Randomized Controlled Trial Protocol for Evaluating the Effect of Group Education on Postmenopausal Sexual Dysfunction.

OBJECTIVES: This study primarily aimed to determine the effect of group education on sexual dysfunction in postmenopausal women referred to health centers in Hamadan, Iran. METHODS: This randomized controlled clinical trial conducted on 90 postmenopausal women from October 2018 to March 2019. Postmenopausal women who met the inclusion criteria and received approval of a psychiatrist were randomly divided into intervention and control groups (n = 45 in each group). They completed the demographic questionnaire and the Female Sexual Function Index questionnaire. Thereafter, four sessions of group training were conducted for women in the intervention group; these women were followed up for 1 month after the last training session. Data were analyzed using the SPSS ver. 16 software, and descriptive statistics and ANCOVA/ANOVA test were used for data analysis. RESULTS: We found that the two groups were homogenous in most of the demographic variables and the data were normal. The total mean score of sexual function and standard deviation after the intervention was 23.70 ± 3.67 in the intervention group and 19.94 ± 3.64 in the control group, indicating that these scores were significantly higher in the intervention group than in the control group (P < 0.001). CONCLUSIONS: Based on the results, group training is recommended to reduce sexual dysfunction in postmenopausal women at health centers.

Effect of Combined Herbal Capsule Menohelp on Hot Flashes and Night Sweats in Postmenopausal Women: A Single-Blind Randomized Controlled Trial.

OBJECTIVES: Hot flashes and night sweats are the most common and annoying consequences of menopause. The present study aimed to investigate the effect of a combined herbal capsule (black cohosh, soy, potato, chaste tree, and burdock) on hot flashes and night sweats in postmenopausal women. METHODS: The present study was a randomized clinical trial conducted on postmenopausal women who were referred to Hamadan health centers in 2018-2019. The patients were distributed randomly in two groups of 85 individuals using the permuted block technique. The intervention group received the Menohelp capsule 550 mg twice daily for eight weeks and those in the control group received placebo. Data was obtained using a demographic questionnaire and a night sweat checklist one week before and eight weeks after the intervention. Data analysis was done using Stata 13. RESULTS: Data analysis revealed that means of hot flashes duration, frequency and intensity did not significantly decrease in the postintervention phase as compared to the pre-intervention phase in both the groups (P > 0.05). Comparative analyses of frequency and intensity of night sweats in the two groups revealed that both variables decreased after intervention with the Menohelp capsule (P < 0.05). CONCLUSIONS: This study revealed that combined herbal medicine (Menohelp) was effective in reducing the frequency and intensity of night sweats. Therefore, it can be used to reduce night sweats in postmenopausal women.

Postpartum women's perception of stressors in the delivery ward: a qualitative study.

OBJECTIVE: Delivery is a challenging event in women's lives. What happens during childbirth is stressful for most women. Regarding the short and long-term effects of stressors of the delivery ward on childbirth and neonatal outcomes, and given that understanding the stressors are influenced by existing social culture and factors, the present qualitative study was conducted to investigate women's perception of stressors in the delivery ward. Participants were 13 newly delivered women who were monitored in the recovery room at the Fatemieh Hospital of Hamadan, Iran. Purposive sampling was performed and continued until data saturation. The data collection method was in-depth and semi-structured. RESULTS: The content analysis of qualitative data led to the emergence of two themes of human stressors and environmental stressors as well as four categories; i.e., personal factors, care staff-related factors, environmental factors, and equipment-related factors. The research findings indicated that several personal, environmental, staff-related, and equipment-related factors could lead to stress in the labor and delivery ward. Although ignoring them and increasing stress during childbirth may jeopardize the childbirth consequences, most of them are ignored and overlooked. It is necessary to consider measures to control these factors as much as possible.

Effects of ear and body acupressure on labor pain and duration of labor active phase: A randomized controlled trial.

OBJECTIVES: This study sought to compare the effects of multi-point ear and body acupressure on labor pain and the duration of labor active phase. DESIGN: Three-armed randomized controlled trial. SETTING: Kowsar Hospital, Qazvin, Iran. INTERVENTION: Participants in the body acupressure group received acupressure on GB21, GB30, BL32, LI4, and SP6 points, each for two minutes, at cervical dilation of four, six, and eight centimeters. For participants in the ear acupressure group, adhesive auriculotherapy-specific Vaccaria seeds were attached to their auricles on the zero, genitalia, Shen Men, thalamic, and uterine 1 and 2 acupoints. The seeds were compressed every thirty minutes, each time for thirty seconds. Participants in the control group received routine care services. MAIN OUTCOME MEASURES: Labor pain intensity was assessed using a visual analogue scale at cervical dilation of four and ten centimeters. RESULTS: While there was no significant difference between mean scores of pain among three groups, mean score of labor pain in both acupressure groups was significantly less than that in the control group (P < 0.001). However, the difference between the acupressure groups was not statistically significant (P = 0.12). Moreover, the duration of labor active phase in the ear acupressure group was significantly less than those in the body acupressure and the control groups (P < 0.001). CONCLUSION: Ear acupressure was significantly effective in reducing labor pain and shortening labor active phase. However, body acupressure solely reduces labor pain. Therefore, ear acupressure can be used to reduce labor pain and shorten labor active phase.

Depression, anxiety, stress, and dysmenorrhea: a protocol for a systematic review.

BACKGROUND: Dysmenorrhea is one of the most common menstrual disorders and is influenced by various factors. Psychological disorders including anxiety, depression, and stress have been suggested as influencing dysmenorrhea, but previous findings are inconsistent. This study will investigate the relationship between depression/anxiety/stress and dysmenorrhea using a systematic review and meta-analysis. METHODS: Online databases including PsycINFO, Scopus, PubMed, Science Direct, ProQuest, ISI Web of Knowledge, and Embase will be searched. Appropriate keywords and MeSH terms will be used to retrieve the journal papers published from 1990 until the end of December 2019. To improve search coverage, the reference lists of all included studies will be reviewed to find eligible papers. Inclusion criteria include the following: descriptive, cohort, case-control, and cross-sectional studies; the relationship between depression/anxiety/stress and dysmenorrhea being an objective of the study; and published in peer-reviewed journals. The paper selection, data extraction, and quality assessment of selected studies will be performed independently by two researchers, and disagreements will be resolved through discussions. The Newcastle-Ottawa Quality Assessment Scale will be used to assess the quality of selected studies. A quantitative synthesis will be performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) via the STATA software, if retrieving enough number of studies with no severe methodological heterogeneities. Otherwise, qualitative synthesis will be used to report the findings. DISCUSSION: To the best of our knowledge, this will be the first systematic review on this topic. Performing an inclusive search in major databases over a wide timescale is one key strength of the proposed study and will maximize the coverage of the original research studies on this topic. Results of present study are expected to lead to deeper understanding the relationship between common mental health conditions and dysmenorrhea. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42018102199.

Comparing the effect of auricular acupressure and body acupressure on pain and duration of the first stage of labor: study protocol for a randomized controlled trial.

BACKGROUND: Labor pain is one of the leading causes of fear of childbirth. Acupressure is a non-pharmacological pain relief method that has shown promising results in relieving this pain. The present study is designed to compare the effects of body acupressure at multiple points and auricular acupressure on the pain and duration of labor. METHODS/DESIGN: In a randomized controlled trial, 90 primigravida women who attend for childbirth will be randomly assigned to one of three groups (intervention groups of either body acupressure or auricular acupressure; control, consisting of routine care). Computer-generated six-block randomization techniques will be used to determine the allocation sequence with a 1:1:1 ratio. To hide the allocation, the type of intervention will be written according to the generated sequence and put in opaque envelopes; these as well as questionnaires will be encoded. The pain score for all participants will be measured at the peak uterine contraction at 4-cm cervical dilation and at 10-cm dilation based on a visual analog scale (VAS). The duration of the active phase of labor in these groups will be recorded too. Data will be imported into SPSS-16 software. First, normality of the data distribution will be investigated. To compare labor duration among the research groups, ANOVA will be used, which will be followed, in case of significance, by the Scheffe post hoc test. Furthermore, Chi-squared test will be used to compare the categorized demographic variables and ANOVA or Kruskal-Wallis tests will be used to compare the quantitative variables in the studied groups. A significance level of 0.05 is considered significant. DISCUSSION: In this study the effect of auricular acupressure and body acupressure on pain and duration of first stage of labor will be compared. TRIAL REGISTRATION: Iranian Registry of Clinical Trials, IRCT20180218038789N1. Registered 2018-03-04; pre result.

The Effect of Exercise Plan Based on FITT Protocol on Primary Dysmenorrhea in Medical Students: A Clinical Trial Study.

BACKGROUND: We aimed to investigate the effects of exercise based on a specific protocol on the severity and duration of primary dysmenorrhea in students residing in dormitories of Hamadan University of Medical Sciences, western Iran in 2017. STUDY DESIGN: Randomized controlled trial study. METHODS: Overall, 86 students (43 in the interventional group and 43 in the control group) with mild to moderate dysmenorrhea were enrolled. The exercise based on the FITT protocol (Intensity of exercise, time of exercise, and type of exercise) was implemented for the interventional group in 8 weeks. The McGill Pain scale was used to determine the severity of pain in dysmenorrhea. Duration of pain was calculated in terms of the day. Research data were analyzed using SPSS 20 and the significance level was considered 0.05. RESULTS: The mean dysmenorrhea severity in the first menstrual cycle after the intervention in intervention group was significantly lower than the control group (3.06 (1.78) and 4.74 (2.14), respectively) and in the second menstrual cycle (2.01 (1.54) and 4.61 (2.01) respectively) (P<0.001). The mean duration of dysmenorrhea in the first menstrual cycle after the intervention in intervention group was less than the control group (1.29 (0.92) and 2.32 (1.26) respectively) P<0.001) and in the second menstrual cycle (0.94 (0.93) and 2.13 (1.24) respectively) P<0.001). CONCLUSION: Sports activities based on a certain and organized protocol could improve dysmenorrhea.

Prevalence and predictors of food insecurity among pregnant women: A cross sectional study in Qazvin Province, Iran.

INTRODUCTION: Food insecurity is associated with adverse health consequences in women, especially pregnant ones. Present study is aimed to investigate prevalence and predictors of food insecurity among pregnant women. METHOD: A cross-sectional study was conducted on 394 pregnant women in Qazvin during November 2016-May 2017. The Household Food Insecurity Access Scale (HFIAS) was used to assess food insecurity among pregnant women. Besides, the relationship of demographic, midwifery and socioeconomic factors was investigated using Chi-squared and logistic regression tests. Then, the obtained data were analyzed in Stata-12 software at the significance level of 0.05. FINDINGS: Nearly 44% of the participants had food insecurity. In multivariate analysis, only husbands' unemployment and unwanted pregnancy were associated with food insecurity; thus, the chance of food insecurity among women with unemployed husband was higher than the women with employed husband by 4.7 times [OR (95% CI) = 4.69(1.64, 13.42)]. Furthermore, the probability of food insecurity among the participants with unwanted pregnancy was twice more than those with wanted pregnancy [OR (95% CI) = 2.07(1.14, 3.74)]. CONCLUSION: Unemployed husband and unwanted pregnancy are related to food insecurity among pregnant women. Nevertheless, due to the nature of this study, it was not possible to clearly specify the path of such a relationship. To reduce food insecurity among pregnant women, it is essential to take all the necessary measures for providing financial supports for pregnant women through different ways in order to reduce the stress and worries caused by financial burden of pregnancy, and to improve nutrition quality and eating behaviours among pregnant women.

The relationship between food security and quality of life among pregnant women.

BACKGROUND: Household food insecurity through influencing the quality and sufficiency of nutrition can have considerable effects on individuals' health. Previous studies have shown the relationship between household food insecurity and quality of life among adults, infants, and people of minority ethnicity. However, no studies have been conducted on household food insecurity and quality of life among pregnant women. This study aimed to investigate the effect of food insecurity on quality of life among pregnant women in Qazvin city, Iran. METHODS: This cross-sectional study was conducted between May 2017 and November 2017 on 394 pregnant women. A random cluster sampling method was used to select eight urban health and medical centers from four geographical regions of Qazvin city, Iran. In the selected centers, pregnant women were recruited using eligibility inclusion criteria. Data was collected using the SF-36 Health-related Quality of Life, Household Food Insecurity Access Scale and a demographic questionnaire for recording the women's gestational and demographic information through interviews. Descriptive and inferential statistics including Chi-square test, one-way analysis of variance with Bonferroni post-hoc test and multiple linear regression were used for data analysis. P < 0.05 was considered statistically significant. RESULTS: Food insecurity was reported in 43.9% of the pregnant women. Overall pregnant women's quality of life had the highest score (Mean ± SD) in the domain of 'social performance' (76.4 ± 21) and the lowest one in the domain of 'role limitation due to physical reasons' (60.5 ± 43). Pregnant women with food insecurity had the lowest score in role limitation due to physical reasons domain of quality of life (68.6 ± 40.4, 61.3 ± 45.5 & 51.3 ± 47.7 respectively for mild, moderate and sever food insecurity). The results of multiple linear regression showed that one unit reduction of household food security significantly decreased the total quality of life score by 5.2 score (95% CI: -9.7, - 0.7) among the mild food insecure group, 10.8 score (95% CI: -17.1, - 4.6) among the moderate food insecure group and 14.1 score (95% CI: -19.7, - 8.5) among the sever food insecure group. CONCLUSIONS: Screening of the household food security status during the primary prenatal care can identify high-risk pregnant women to improve the quantity and quality of their diet. Moreover multi-level actions including policy-making, supplying resources, and providing appropriate services are needed to ensure that pregnant women have access to high-quality foods.

Effect of Marital Relationship Enrichment Program on Marital Satisfaction, Marital Intimacy, and Sexual Satisfaction of Infertile Couples.

BACKGROUND: Infertile couples only think of having children during their sexual intercourse, and their constant concern about this issue increases their stress level. Psychosocial and social stress leads to decreased life satisfaction, increased marital problems, and reduced sexual confidence. This study aims to determine the effect of enrichment program on marital and sexual satisfaction as well as marital intimacy among infertile couples. MATERIALS AND METHODS: This randomized controlled clinical trial was conducted on 50 infertile couples in 2013 in Hamedan. The marital relationship enrichment program was taught to the experimental group during seven 90 minutes sessions. Enrich marital satisfaction, Linda Berg sexual satisfaction, and marital intimacy questionnaires were completed by both groups in 3 pretest steps immediately after the end of training sessions, and 8 weeks later. The results were analyzed in STATA11 software using t test, Chi-square, ANCOVA, RM-ANOVA, and Bonferroni post-hoc test. To check the data normality, Kolmogorov-Smirnov test was used. P<0.05 was considered significant. RESULTS: Comparison of mean scores related to pretest on the one hand and immediately after the test in 8 week later on the other hand showed marital relationship enrichment program significantly increased marital and sexual satisfaction (P<0.001). Also, mean score of marital intimacy immediately after the test (P=0.04) and 8 weeks after the test (P<0.001) significantly increased in comparison with the pretest under the influence of the program. CONCLUSION: Enrichment training can increase marital intimacy and also marital and sexual satisfaction in infertile couples (Registration Number: IRCT201604299014N97).