The Effects of Thiamine Supplementation on General Health and Infertility Treatment Outcomes in Women with Polycystic Ovary Syndrome: A Triple-Blinded Randomized Placebo-Controlled Clinical Trial.

BACKGROUND: The aim of this study was to evaluate the effects of thiamine (vitamin B1) on general health and infertility treatment outcomes in women with polycystic ovary syndrome (PCOS). MATERIALS AND METHODS: The study is a triple-blinded, randomized, placebo-controlled clinical trial performed on 64 infertile women with PCOS referred to Sarem Hospital in Tehran, Iran. The primary outcomes of the study were general health and infertility treatment outcomes. Eligible women were randomly assigned to the vitamin B1 group (n=32, vitamin B1 tablet at a dose of 300 mg/day for 4 weeks) or the placebo group (n=32, placebo tablet daily for 4 weeks). A general health questionnaire was completed before and after the intervention by both groups, and treatment success was evaluated at the end of the study. Data were analyzed using SPSS software ver.16 P<0.05 was considered statistically significant. RESULTS: The mean age of participants in the vitamin B1 (VB1) group was 30.4 ± 3.27 years and in the placebo (Pl) group was 29.1 ± 2.66 years with the mean duration of marriage 12.7 ± 3.01 and 13.2 ± 2.97 years respectively. Our results showed that there were significant differences between the two groups in overall score (P<0.001) and scores for all domains of the general health questionnaire including somatic symptoms (P<0.001), anxiety and insomnia (P<0.001), social dysfunction (P=0.028), and severe depression (P<0.001) after the intervention. Four weeks consumption of vitamin B1 also resulted in higher numbers of positive pregnancy tests (P=0.006), although the number of fetuses was not significantly different between the two groups after the intervention. CONCLUSION: The results of the current study support a possible favourable effect of vitamin B1 on improving general health, infertility treatment outcome, and retrieved follicle count without changing the number of fetuses in women with polycystic ovary syndrome (registration number: IRCT201510266917N3).

The Effect of Metabolic Persian Diet on Ovulation Induction in Infertile Women.

Introduction: Infertility is an important issue with a high social and psychological burden. From the perspective of Persian Medicine (PM), uterine cold temperament is one of the important causes of female infertility. Aim: The aim of this study was to study the effect of PM or Iranian traditional medicine on improving ovulation and fertility. Methods: From January 2017 to August 2017, sixty infertile women with eugonadotropic ovulation disorder were randomly divided into two groups. Both groups were treated with clomiphene citrate, except that the intervention group also received metabolic Persian diet (MPD). In each cycle, the dominant follicles and endometrium were investigated with ultrasound. At the end of the cycle, beta human chorionic gonadotropin (ß-HCG) was evaluated and if positive, another ultrasound was performed two weeks later to confirm early pregnancy. Results: The number of dominant follicles from the first to third cycle increased from 2.15 ± 1.14 to 2.28 ± 0.61 in the intervention group and decreased from 1.86 ± 0.79 to 1.30 ± 0.47 in the control group. The dominant follicle size changed from 16.00 ± 4.08 to 18.78 ± 2.78 and from 15.05 ± 3.11 to 15.80 ± 3.89 in the intervention and control groups, respectively. But endometrial thickness did not change significantly in the intervention group. Pregnancy results based on ß-HCG and ultrasound findings were positive in 19 and 16 patients in the intervention group and in 10 and 7 patients in the control group, implying significantly higher numbers in the first group. Conclusion: It seems that MPD may be effective in the success of ovulation induction.

The effect of delivery ball and warm shower on the childbirth experience of nulliparous women: a randomized controlled clinical trial.

INTRODUCTION: Childbirth is a unique experience that affects women's life. Midwives can play an effective role in creating positive birth experiences for women using non-pharmacological and supportive methods. Accordingly, this study aims to determine the effect of delivery balls and warm showers on childbirth experiences of primiparous women. METHODS: This clinical trial was conducted on primiparous pregnant women who referred to the Motazedi Hospital in Kermanshah, Iran. Sampling was done from eligible individuals by a continuous method, and pregnant women were assigned to the three groups of delivery balls plus warm showers or A (n = 35), delivery balls or B (n = 35), and control or C (n = 35). The use of the ball at the dilation of 4 cm was similar in the two groups of A and B, but the first group used a warm shower at the dilatation of 7 cm as well. The control group also received routine delivery care. Besides, demographic information forms consisting of the pregnancy history and some information about the mother and her infant were completed. Additionally, childbirth experience questionnaires (CEQ) were completed by the women two hours after childbirth. The analysis of intervention effects was performed as per-protocol analysis. RESULTS: There was a statistically significant difference in the mean score of the childbirth experience between the two groups of A and C (p = 0.001) after the intervention as well as between the groups of B and C (p = 0.001). CONCLUSION: The use of delivery balls and warm showers was effective in creating a positive childbirth experience. To create a positive childbirth experience in mothers, the use of both interventions (delivery balls and warm showers) is recommended. TRIAL REGISTRATION: TCTR 20200408002 . Prospectively registered on March 21, 2020.

Effect of tinnitus distress on auditory steady-state response amplitudes in chronic tinnitus sufferers.

Tinnitus is a bothersome disorder of primarily unknown etiology that affects a large number of people worldwide. Tinnitus distress is the most common clinical complaint by tinnitus sufferers because it strongly affects their personal and social life. Many studies have been carried out to determine the relation between tinnitus pathophysiology and electrophysiological findings such as the auditory steady-state response (ASSR). The results of such studies have been contradictory. The current study aimed to detect a possible relation between tinnitus distress and ASSR amplitudes. The tinnitus participants were divided into high and low distress subgroups according to their tinnitus handicap inventory (THI) scores. The ASSR stimuli were carrier frequencies with low (500 Hz), mid (2000 Hz), and high (4000 Hz) amplitude-modulated tones. ASSR amplitudes were calculated in anterio-frontal (F3, Fz, F4), centro-frontal (FC3, FCz, FC4), left auditory (T3, C5, C3) and right auditory (C4, T4, C6) regions of interest (ROI). Twenty-four right-handed subjects with non-pulsatile chronic tinnitus and 23 normal matched participants participated in this study. For recording ASSR amplitudes were used from 32-electrode EEG recording. Two-way repeated-measurement ANOVA was used to compare the ASSR amplitudes. The findings showed that the ASSR amplitudes in the tinnitus group with low distress were higher (better) than in the group with high distress (p < 0.001). This finding was seen in anterio-frontal and right auditory regions and at all carrier frequencies. The results indicated that there is a relation between the ASSR amplitude and the degree of tinnitus distress as measured by the THI questionnaire.

The Effect of Combined Vitamin C and Vitamin E Supplementation on Oxidative Stress Markers in Women with Endometriosis: A Randomized, Triple-Blind Placebo-Controlled Clinical Trial.

Background: Endometriosis is a chronic and estrogen-dependent pelvic inflammatory disease, which may have various causes, such as oxidative stress. Dysmenorrhea, dyspareunia, and pelvic pain are well-known symptoms of endometriosis. The present clinical trial assessed the role of supplementation with antioxidant vitamins on the indices of oxidative stress as well as the severity of pain in women with endometriosis. Materials and Methods: We enrolled 60 reproductive-aged (15-45 years) women with pelvic pain in this triple-blind clinical trial. They had 1-3 stages of laparoscopic-proven endometriosis. The participants were randomized to group A (n = 30), given vitamin C (1000 mg/day, 2 tablets of 500 mg each) and vitamin E (800 IU/day, 2 tablets of 400 IU each) combination, or group B (n = 30), given placebo pills daily for 8 weeks. Results: Following treatment with vitamin C and vitamin E, we found a significant reduction in MDA and ROS compared with the placebo group. There was no significant decline in total antioxidant capacity after treatment. However, the severity of pelvic pain (p value <0.001), dysmenorrhea (p value <0.001), and dyspareunia (p value <0.001) significantly decreased in the treatment group after 8 weeks of supplementation. Conclusions: The present findings support the potential role of antioxidants in the management of endometriosis. The intake of vitamin C and vitamin E supplements effectively reduced dysmenorrhea severity and improved dyspareunia and severity of pelvic pain.

Cold Therapy and Respiratory Relaxation Exercise on Pain and Anxiety Related to Chest Tube Removal: A Clinical Trial.

BACKGROUND: Current strategies to control pain and anxiety of chest tube removal are not efficacious. The aim of this study is to determine the effects of cold therapy and respiratory relaxation exercise on pain and anxiety of chest tube removal. MATERIALS AND METHODS: A parallel single-blind clinical trial study was conducted in Imam Khomeini Hospital, Iran, on 120 patients. Participants were randomized into 4 groups of 30. Numeric Rating Scale was used to assess pain and anxiety. One-way ANOVA test and Fisher's exact test were used to analyze demographic data. The Kruskal-Wallis test was used to compare the severity of pain and anxiety between groups; the Friedman and Mann-Whitney test were used to compare the severity of pain and anxiety within groups with a significance level of 0.05. RESULTS: Pain intensity was weak before chest tube removal and there was no significant difference in basal pain. Pain immediately after chest tube removal was significantly higher than other times in each group (χ 2 = 57.16, χ 2 = 63.70, χ2 = 46.49, χ 2 = 59.04, df = 3, p < 0.001). There was no significant difference in pain score immediately (p = 0.052) and 15 min (p = 0.329) after Echest tube removal in experimental groups compared to the control group. No significant difference was found between control and experimental groups in anxiety score immediately (p = 0.995) and 15 min (p = 0.976) before chest tube removal. CONCLUSIONS: Mentioned methods were not effective in reducing pain and anxiety. It is suggested to investigate effects of different methods of removing chest tubes and applying cold with a larger sample size.

The Relationship between Psychoacoustic and Electrophysiological Assessments of Temporal Resolution.

BACKGROUND: Temporal resolution is essential to speech acoustic perception. However, it may alter in individuals with auditory disorders, impairing the development of spoken and written language. The envelope of speech signals contains amplitude modulation (AM) that has critical information. Any problem reducing the listener's sensitivity to these amplitude variations (auditory temporal acuity) is likely to cause speech comprehension problems. The modulation detection threshold (MDT) test is a measure for evaluating temporal resolution. However, this test cannot be used for patients with poor cooperation; therefore, objective evaluation of MDT is essential. PURPOSE: The main aim of this study is to find the association between the auditory steady-state response (ASSR) and psychoacoustic measurement of MDT at different intensity levels and to assess the amplitude and phase of ASSR as a function of modulation depth. DESIGN: This was a correlational research. STUDY SAMPLE: Eighteen individuals (nine males and nine females) with normal hearing sensitivity, aged between 18 and 23 years, participated in this study. DATA COLLECTION AND ANALYSIS: ASSR was recorded at fixed AM rates and variable AM depths for carrier frequencies of 1,000 and 2,000 Hz with varying intensities. The least AM depth, efficient to evoke an ASSR response, was interpreted as the physiological detection threshold of AM. The ASSR amplitude and phase, as a function of AM depth, were also evaluated at an intensity level of 60 dB hearing level (HL) with modulation rates of 40 and 100 Hz. Moreover, the Natus instrument (Biologic Systems) was used for the electrophysiological measurements. An AC40 clinical audiometer (Intra-acoustic, Denmark) was also used for the psychoacoustic measurement of MDT in a similar setting to ASSR, using the two-alternative forced choice method. Pearson's correlation test and linear regression model and paired t-test were used for statistical analyses. RESULTS: A significant positive correlation was found between psychoacoustic and electrophysiological measurements at a carrier frequency of 1000 Hz, with a modulation rate of 40 Hz at intensity levels of 60 dB HL (r = 0.63, p = 0.004), 50 dB HL (r = 0.52, p = 0.02). A significant positive correlation was also found at a carrier frequency of 2000 Hz, with a modulation rate of 47 Hz at 60 dB HL (r = 0.55, p = 0.01) and 50 dB HL (r = 0.67, p = 0.002) and a modulation rate of 97 Hz at 60 dB HL (r = 0.65, p = 0.003). Moreover, a significant association was found between the modulation depth and ASSR amplitude and phase increment at carrier frequencies of 1,000 and 2000 Hz, with modulation rates of 40 and 100 Hz. CONCLUSION: There was a significant correlation between ASSR and behavioral measurement of MDT, even at low intensities with low modulation rates of 40 and 47 Hz. The ASSR amplitude and phase increment was a function of modulation depth increase. The findings of this study can be used as a basis for evaluating the relationship between two approaches in the clinical population.

Evaluation of the effect of vitamin D3 supplementation on quantitative and qualitative parameters of spermograms and hormones in infertile men: A Randomized controlled trial.

BACKGROUND: 25-Hydroxy Vitamin D3 is known to have an effect on reproductive system in both genders and may change the semen parameters in men. OBJECTIVE: Our study aimed to evaluate the effect of oral vitamin D3 supplementation on spermogram quantitative and qualitative parameters in infertile men. MATERIALS AND METHODS: This study was a triple-blind randomized controlled trial involving 62 infertile men with impaired spermatogonial tests. They were randomly divided into placebo and D3-supplemented groups. Spermograms and tests for LH (Luteinizing Hormone), FSH (Follicle Stimulating Hormone), TT (Total Testosterone), FT (Free Testosterone), SHBG (Sex Hormone Bonding Globulin), FAI (Free Androgen Index) and vitamin D3 levels were performed before and after the intervention. RESULTS: There were no significant differences between the two groups in parameters of the spermograms or serum levels of LH, FSH, TT, and FAI. In the intervention group, SHBG was significantly decreased after intervention (p = 0.01) and there was a significant increase in FT in the placebo group (p = 0.03). CONCLUSION: The intake of vitamin D3 did not change the quality and quantity of spermograms and serum levels of LH, FSH, TT, and FAI but affected FT and SHBG. Further studies are still needed to clarify the biological role of vitamin D3 on fertility particularly on male fertility. This study lays a foundation for more extensive studies on male infertility.

The relationship between health life style and spermogram Indicators among infertile men: preliminary data.

OBJECTIVE: Inappropriate life style has destructive effects on sperm quality and, male fertility, so that lifestyle modification may improve spermogram indexes preliminary data. This study aimed to determine the relationship between health life style and spermogram Indicators among infertile men. This analytical descriptive cross-sectional study was conducted on 199 infertile men. The data were collected through the socio-demographic and Health Promoting Lifestyle Profile questionnaires Descriptive statistics independent t-test and Pearson correlation were used to analyze the data through SPSS. RESULTS: The mean (standard deviation) of total score of the health promoting lifestyle was (2.39 ± 0.39). The highest mean score was in Health Responsibility subscale (2.51 ± 0.52) and the lowest mean score was in the nutrition subscale (2.24 ± 0.44). Stress management showed significantly correlated with sperm morphology (p = 0.025). Also, spiritual growth with the Sperm concentration (p < 0.001), and sperm motility (p = 0.004) were statistically correlated, and health responsibility dimensions were statistically correlated with the Sperm concentration (p = 0.003) and sperm motility (p = 0.002). Considering that the mean of total score of the health promoting lifestyle and its correlation with some of spermogram indicators shows a need for improving lifestyle in infertile men who referred to infertility clinics.

The effect of aromatherapy massage with lavender and chamomile oil on anxiety and sleep quality of patients with burns.

INTRODUCTION: Regarding the importance of anxiety management and improvement of the quality of sleep in patients with burn injuries, this study aimed to determine the effect of aromatherapy massage (using aromatic oils of lavender and chamomile) on the anxiety and sleep quality of the patients with burn injuries. METHOD: In a quasi-experimental study, 105 patients with burns were recruited by convenience sampling method and then assigned into three groups (control, placebo massage, and combined aromatic oil massage). The study intervention was performed 20min before bedtime in three sessions, within a week. The control group was only under daily routine care. The study data were collected using the Persian version of Spielberg's anxiety scale and the Pittsburgh Sleep Quality Inventory. Descriptive and inferential statistical tests were used to analyze the data in SPSS version 20. RESULTS: The results showed a significant difference among the three groups in terms of anxiety score (P<0.001) and in terms of sleep quality after the intervention (P=0.027). CONCLUSION: Since the aromatherapy massage as a non-pharmacological and simple method can improve the anxiety and quality of sleep in patients with burns, it is suggested that nurses and burn medical care team apply it to reduce burn patients' anxiety and promote their sleep quality. Applying massage alone also reduces anxiety in burn survivors.

Comparison of Single and Combined Effects of Nature Sounds and Foot Sole Reflexology Massage on the Level of Consciousness in Traumatic Comatose Patients: A Randomized Controlled Clinical Trial.

Consciousness disturbances are the most common posttraumatic complications. The purpose of this study was to compare the single and combined effects of nature sounds and foot sole reflexology massage on level of consciousness in traumatic comatose patients. This randomized controlled clinical trial was conducted in 2 teaching hospitals in an urban area of Iran. Samples were 120 traumatic comatose patients who were randomly assigned into control, nature sounds, foot reflexology massage, and nature sounds plus foot sole reflexology massage groups. Patients in all groups received routine care. Interventions were performed twice a day for 2 weeks, each time for 30 minutes. The patients' level of consciousness was assessed using the Glasgow Coma Scale before, 1 week, and 2 weeks after the intervention. The groups had no significant differences in the mean scores of the consciousness level before, 1 week after, and the last day of the intervention. Also, there was a significant difference in the number of patients who regained full consciousness (P = .001) in the intervention groups compared with the control group. Significant differences in the number of days of consciousness were reported in at least one of the groups compared with other groups (P = .001). This difference was significant in the control group compared with the foot reflexology massage group (P = .032), as well as the nature sounds plus foot sole reflexology massage group (P = .001). Single or combined interventions can increase the level of consciousness in comatose patients and reduce the duration of coma.

Comparison of the effects of inhalation aromatherapy using Damask Rose aroma and the Benson relaxation technique in burn patients: A randomized clinical trial.

BACKGROUND: Burn injuries are often accompanied by painful and distressing consequences, which can lead to long-term psychological issues. The most common form of anxiety in burn patients is pain anxiety. It is described as the feeling of fear and pain prediction caused by painful procedures. AIM: To compare the effects of inhalation aromatherapy using damask rose aroma and the Benson relaxation technique on pain anxiety in burn patients. METHODS: This randomized clinical trial was conducted on 132 patients hospitalized in Motahari Burn Hospital from October 2017 to March 2018. The subjects were selected using a sequential sampling method. Next, they were randomly allocated by the Permuted block randomization method into four groups of rose aroma (5 drops of 40% rose aroma), the Benson relaxation technique, combined rose aroma-Benson relaxation and control. The interventions were performed for three consecutive days and once a day for 20 min, and each session lasted from 45 to 30 min before the daily dressing change. Data was collected using the Persian version of burn specific pain anxiety scale (BSPAS). Data was analyzed using descriptive and inferential statistics via the SPSS software version 16. RESULTS: Immediately after the intervention, on the first, second and third days, significant differences in pain anxiety among four groups were reported. On the first day, the Scheffé ad hoc test indicated statistically significant differences in pain anxiety between all groups (p < 0.001), except rose aroma-plus-Benson relaxation and rose aroma groups (p = 0.15). On the second and third days, there were significant differences between the groups in pain anxiety (p < 0.001). Furthermore, after wound dressing, on the first, second and third days, statistically significant differences in pain anxiety among four groups were reported. On the first day, the Scheffé ad hoc test revealed statistically significant differences in pain anxiety between all groups (p < 0.001). On the second and third days, there were statistically significant differences in pain anxiety between the groups (p < 0.001), except the rose aroma and Benson relaxation groups. Immediately after the intervention, the maximum effect size was on the first day in the group of rose aroma-plus-Benson relaxation and the lowest effect size was on the first day in the Benson relaxation group. However, after wound dressing, the maximum effect size was on the third day in the rose aroma-pus-Benson relaxation group and the lowest effect size was on the first day in the Benson relaxation group. CONCLUSION: The combination of the rose aroma and Benson relaxation has a synergistic effect and has more effects in the reduction of pain anxiety in burn patients than a single intervention. Health care providers can provide these interventions simultaneously and help reduce pain anxiety in burn patients before conducting painful interventions.

Comparison of the effects of nature sounds and reflexology on hemodynamic indices among traumatic comatose patients: A randomized controlled clinical trial.

Background Traumatic comatose patients may experience disturbances in hemodynamic indices due to the nature of their disorder. This study aimed to compare the effects of nature sounds and reflexology on hemodynamic indices in traumatic comatose patients. Methods This randomized clinical trial using a factorial design was conducted on 120 traumatic comatose patients in two teaching hospitals in two urban areas of Iran. The patients were selected using a sequential sampling method and assigned into randomized quadruple blocks as control, nature sounds, reflexology and nature sounds-reflexology (combined) groups. The interventions were performed twice daily in two consecutive days lasting 30 min each time. The hemodynamic indices were measured before, and immediately, 30 min, and 2 h after the intervention using calibrated monitors. Descriptive and inferential statistics, including one-way ANOVA, Scheffe ad hoc, repeated measure ANOVA, Bonferroni ad hoc Chi-square test and Fisher's exact tests were used for data analysis via the SPSS software V.16. Results Significant differences were reported in terms of the mean arterial pressure between the control and reflexology groups (p=0.002), and the combined group (p=0.008) immediately after the interventions. The combined group showed statistically differences in systolic blood pressure compared to the nature sounds (p=0.007) and control (p=0.015) groups 30 min after the interventions. The nature sounds group showed differences in the pulse rate from the reflexology (p=0.048) and control (p=0.015) groups 30 min after the interventions in the second day. Conclusions While the immediate effects of the interventions on induction of the feeling of relaxation and tranquility, and reduction of hemodynamic indices were reported, they diminished over time. Nature sounds and reflexology as low-cost and relaxing tranquilizing methods can be used for the reduction of tension and improvement of hemodynamic indices among traumatic comatose patients.

Comparison the effects of topical application of olive and calendula ointments on Children's diaper dermatitis: A triple-blind randomized clinical trial.

This study compares the effective of of topical application of olive and calendula ointments on childrens' diaper dermatitis (DD). This triple-blind clinical trial was conducted on 73 healthy children under the age of 2 years with non-severe and not infected DD, referred to a pediatric healthcare center in Tabriz, Iran. The children were assigned to 1.5% olive ointment (n = 37) and 1.5% calendula ointment (n = 39) using a random block method with the ratio of 2:2. The severity of DD in both groups was measured and compared on a six-point scale on days 0 (before the intervention) and 3, 5, and 7 after interventions. The findings releaved there was not significant stastistical difference between the olive oil and calendula groups in terms of severity of DD in the third, fifth and seventh days. No adverse effect was reported from either of the medications in this study. The external validity and consequently the ability to generalize the findings may be diminished as this study was conducted at a single site. Owing to olive ointment and calendula ointment providing the same results in the healing of DD, olive ointment can be used as an alternative case to DD.

Evening primrose oil and labour, is it effective? A randomised clinical trial.

The purpose of the present study was to evaluate the effects of evening primrose oil (EvPO) on the duration of pregnancy and labour. The study was performed as a triple blind placebo controlled randomised clinical trial on nulliparous low-risk women with a certain gestational age of 40 weeks of pregnancy and a Bishop score of less than 4. In the case group (EvPO group), EvPO capsules were administered, 1000 mg, twice daily, for 7 days, and in the control group, placebo was administered similarly. The women of the two groups were followed up to delivery. In total, 80 women finished the study (40 in each group). The women of the two groups did not have significant differences according to age, BMI, Bishop Score at the beginning of the study, gestational age at entering the study, employment status and education level, the number of capsules used and duration of using medications. There was no significant difference between the two groups according to gestational age at delivery, need for induction or augmentation of labour, duration of different stages of labour, neonatal weight and Apgar scores, and the indications for hospital admission. Impact statement What is already known on this subject? Evening primrose oil has been used for the treatment of systemic disorders, which are accompanied with chronic inflammation such as atopic dermatitis, rheumatoid arthritis and psoriasis. Also, it has been proposed for some women's health conditions including breast pain (mastalgia), symptoms of premenstrual syndrome and menopausal symptoms, cervical ripening and induction or augmentation of labour. What do the results of this study add? Evening primrose oil does not have any impact on Bishop Score and the duration of different stages of labour. What are the implications of these findings for clinical practice and/or further research? According to the present study and the other performed studies, there is not enough evidence confirming effectiveness of Evening primrose oil for cervical ripening and duration of labour. It is suggested that pending further data its usage should be limited to experimental RCTs and its use in clinical practice should be prevented. Also, different routes of administration and different dosages should be investigated.

The Relationship Between Job Stress, Personality Traits and the Emotional Intelligence of Midwives Working in Health Centers of Lorestan University of Medical Sciences in 2017.

Introduction and Objective: Job stress is one of the major threats to health and it is associated with many diseases and family problems. Midwives experience high job stress due to the management of delivery emergencies. Personality traits and emotional intelligence can be helpful in confronting environmental pressures and selecting the strategy of coping with useful stress. Thus, the current research was conducted to evaluate the relationship between job stress, personality traits and emotional intelligence in midwives of Lorestan health care centers. Methodology: This research was a cross-sectional and correlational study. Midwives working in all cities of the Lorestan province were randomly selected and they completed the job stress, emotional intelligence and personality traits questionnaires. Data were analyzed using SPSS 16 software and a significance level of p <0.05 was considered. Results: The results of the research showed that mean and standard deviation of job stress, emotional intelligence and personality trait midwives were 94.36 ± 12.98, 11.87 ± 14.30, and 135.51 ± 15.73 respectively. The results showed a negative relationship between intelligence and job stress (r= -0/274, p=0.0001) and no significant relationship was found between personality traits and job stress (r = -0.288, p=0.079). Conclusion: A negative correlation was found between emotional intelligence and job stress, so emotional intelligence can reduce midwives' workplace stress.

Comparison of the Effects of Benson Muscle Relaxation and Nature Sounds on the Fatigue in Patients With Heart Failure: A Randomized Controlled Clinical Trial.

This study was conducted with the aim of comparing the effects of Benson muscle relaxation and nature sounds on fatigue in patients with heart failure. Fatigue and exercise intolerance as prevalent symptoms experienced by patients with heart failure can cause the loss of independence in the activities of daily living. It can also damage self-care and increase dependence to others, which subsequently can reduce the quality of life. This randomized controlled clinical trial was conducted in an urban area of Iran in 2016. Samples were consisted of 105 hospitalized patients with heart failure chosen using a convenience sampling method. They were assigned to relaxation, nature sounds, and control groups using a randomized block design. In addition to routine care, the Benson muscle relaxation and nature sounds groups received interventions in mornings and evenings twice a day for 20 minutes within 3 consecutive days. A 9-item questionnaire was used to collect data regarding fatigue before and after the interventions. Relaxation and nature sounds reduced fatigue in patients with heart failure in comparison to the control group. However, no statistically significant difference was observed between the interventions. Benson muscle relaxation and nature sounds are alternative methods for the reduction of fatigue in patients with heart failure. They are inexpensive and easy to be administered and upon patients' preferences can be used by nurses along with routine nursing interventions.

Safety culture in the maternity unit of hospitals in Ilam province, Iran: a census survey using HSOPSC tool.

INTRODUCTION: Improving quality of maternal care as well as patients' safety are two important issues in health-care service. Therefore, this study aimed to assess the culture of patient safety at maternity units. METHODS: This cross-sectional study was conducted among staffs working at maternity units in seven hospitals of Ilam city, Iran. The staffs included in this study were gynecologists and midwifes working in different positions including matron, supervisors, head of departments and staffs. Data were collected using the Hospital Survey on Patient Safety Culture (HSOPSC). RESULTS: This study indicated that 59.1% of participants reported fair level of overall perceptions of safety and 67.1% declared that no event was reported during the past 12 months. The most positively perceived dimension of safety culture was teamwork within departments in view of managers (79.41) and personnel (81.10). However, the least positively perceived dimensions of safety culture was staffing levels. CONCLUSION: The current study revealed areas of strength (teamwork within departments) and weakness (staffing, punitive responses to error) among managers and personnel. In addition, we found that staffs in Ilam's hospitals accept the patient safety culture in maternity units, but, still are far away from excellent culture of patient safety. Therefore, it is necessary to promote culture of patient's safety among professions working in the maternity units of Ilam's hospitals.

The effect of nature sounds on physiological indicators among patients in the cardiac care unit.

BACKGROUND AND OBJECTIVES: Environmental noises may create physiological and psychological disorders in patients hospitalized in the CCU. Therefore, this study was conducted to investigate the effects of nature sounds on physiological indicators among patients in the CCU. MATERIALS & METHODS: This randomized clinical trial was conducted on 93 patients hospitalized in the cardiac care units of three teaching hospitals in 2016. The patients were selected using the convenient method with three randomized blocks. The patients were assigned into three groups as nature sounds, silence that received a set of headphones without playing sounds, and control groups. In addition to routine care, the patients in the intervention group listened to nature sounds for 30 min using a set of headphones for two days. The patients in the control group only received routine care. In addition to routine care, the patients in the silence group used a set of headphones for 30 min to block noises and no sound was played for them. Physiological indicators such as heartbeat rate, systolic and diastolic blood pressures, respiration rate, and arterial O2 saturation were assessed using monitoring devices. Descriptive and inferential statistics were used for data analysis via the SPSS software. FINDINGS: Nature sounds and silence had no statistically significant effects on physiological indicators. However, a statistically significant difference was reported in the heart rate in the nature sound group before and after the intervention in the first day of the intervention (P = 0.046). In the second day of the intervention, there were statistically significant differences in the diastolic blood pressure in the nature sounds group (P = 0.028), heart rate (P = 0.001) and diastolic blood pressure (P = 0.013) in the silence group, and heart rate (P = 0.014) in the control group before and after the intervention. CONCLUSION: Listening to nature sounds or the use of headphones blocked environmental noises and could influence mean arterial pressure. Future studies can examine the effects of this intervention implemented for a longer term using nature sounds by patients.

Yoga during pregnancy: The effects on labor pain and delivery outcomes (A randomized controlled trial).

OBJECTIVE: To investigate the effects of an antenatal yoga program on perceived maternal labor pain and delivery outcomes. MATERIAL & METHODS: This randomized control trial was conducted with sixty primiparous women, aged 18-35 years old, who were randomly assigned to either an antenatal yoga program or control groups. Labor pain and discomfort level of the participants were measured using a Visual Analogue Scale at cervical dilatation of 3-4 c and at 2 and 4 h after the initial measurement. Demographic and obstetrical information were collected. The antenatal yoga program consisted of a 1-h supervised yoga class, three times a weekly, starting at 26 weeks gestation. . RESULTS: Participants in control group reported higher pain intensity compared to experimental group at 3-4 cm of dilatation (p = 0.01) and at 2 h after the first and the second measurements (p = 0.000). Mothers in the antenatal intervention group that completed the yoga class required a decreased frequency of labor induction in comparison with control group (p = 0.008). In addition, mode of delivery of the intervention group resulted in a lower percentage of cesarean section than control group (p = 0.002). Lastly, the intervention group experienced a shorter duration of the second and third stages of labor. Interval level data was analyzed by using an independent t-test and chi-square. CONCLUSION: Yoga during pregnancy may contribute to a reduction pain of labor and improved adequacy of childbirth.