Predictive power of PEN-3 cultural model in cervical cancer screening among women: a cross- sectional study in South of Iran.

BACKGROUND: Cervical cancer (CC) can be prevented through early detection facilitated by screening as well as an early diagnosis and effective treatment of the precancerous lesions. The present research aimed to determine the predictors of cervical cancer screening (CCS) based on the PEN-3 model constructs. METHODS: A cross-sectional study was conducted between September 2021- March 2022 with 840 women aged 15-49 in the city of Bandar Abbas, in the south of Iran, using a cluster sampling. The participants completed a valid and reliable self-administered questionnaire in person. The questionnaire included demographic characteristics, knowledge toward CC and the constructs of the PEN-3 model toward CCS. A multivariable logistic regression was used to determine the relationship and predictive power of model constructs with behavior as an outcome variable. The data were statistically analyzed in STATA14.2. The p-value < 0.05 was considered statistically significant. RESULTS: A total of 810 questionnaires were analyzed (with a return of 95.63%). The mean and standard deviation of the participants' age was 30.97 ± 5.80 years. Pearson correlation coefficient analysis of all constructs and CCS behavior was statistically significant (P-value < 0.05). The multivariable logistic regression analytic results were enablers toward CCS (coefficient: 0.275) and Nurturers toward CCS (coefficient: 0.182), perceptions toward CCS (coefficient: 0.077) and knowledge toward CC (coefficient: 0.048, marginal significant) were predictors of CCS behavior. For the internal validity of the designed prediction model, a sample of 1000 was selected using the bootstrap sample replacement method which demonstrated the accuracy of the model PEN-3 is about 75% in predicting CCS behavior. CONCLUSIONS: The results of the present research showed that personal factors such as perceptions and interpersonal factors such as enablers and nurturers toward CCS can predict CCS behavior. Therefore, in order to increase the acceptance of CCS in women, a set of intrapersonal and interpersonal factors should be taken into account.

Utilization of cervical cancer screening services and its associated factors in Iran: a case-control study.

BACKGROUND: Considering the high incidence rate of cervical cancer (CC) in Iran, screening is an effective way of reducing the impact of the disease due to early detection. Thus, the recognition of the factors affecting the use of cervical cancer screening (CCS) services is essential.The present study aimed to determine the associated factors of CCS in women living in the suburbs of Bandar Abbas in the south of Iran. METHODS: The present case-control study was conducted between January and March 2022 in the suburban areas of Bandar abbas. Two hundred participants were assigned to the case group and 400 participants were assigned to the control group. A self-constructed questionnaire was used to collect the data. This questionnaire contained demographic information, reproductive information, knowledge of CC, knowledge of CCS and access to the screening. Univariate and multivariate regression analyses were run to analyze the data. The data were analyzed in STATA 14.2 at a significance level of p < 0.05. RESULTS: The mean and standard deviation of participants' age in the case group was 30.33 ± 4.892, and in the control group was 31.35 ± 6.149. The mean and standard deviation of knowledge in the case group was 10.21 ± 1.815 and in the control group was 7.24 ± 2.447. The mean and standard deviation of access was 43.72 ± 6.339 in the case and 37.17 ± 4.828 in the control group. The results of multivariate regression analysis showed the following factors increased the odds of CCS: knowledge (OR medium = 18.697, OR high = 13.413), access (OR medium = 4.028, OR high = 8.126), being married (OR = 3.193), being educated (OR diploma = 2.587, OR university degree = 1.432), middle and high SES (OR Middle = 6.078, OR Upper = 6.608), and not smoking (OR = 1.144). Also, women's reproductive status, including history of sexually transmitted diseases (OR = 2.612), use of oral contraceptives (OR = 1.579), sexual hygiene (OR = 8.718). CONCLUSIONS: In the light of the present findings, it can be concluded that besides increasing suburban women's knowledge, their access to screening facilities should be improved. The present findings showed the need to remove the barriers to CCS in women of low SES to increase the rate of CCS. The present findings contribute to a better understanding of factors involved in CCS.

Increasing cervical cancer screening in Iran: effectiveness of a theory-based educational intervention.

PURPOSE OF STUDY: The high mortality rate of cervical cancer in developing countries is mainly related to inefficient screening programs. The aim of the present study was, thus, to determine the effect of an educational intervention based on BASNEF (Belief, Attitudes, Subjective Norms, and Enabling Factors) model on increasing the rate of cervical cancer screening (CCS) in Bandar Deir in the south of Iran. METHODS: A quasi-experimental educational intervention was made with 202 women participants (101 in the intervention group (IG) and 101 in the control group (CG)) in 2019-20. The sampling was convenience in type. The data were collected using a reliable and valid tripartite questionnaire (demographic information, knowledge, BASNEF constructs). A total number of 14 training sessions were held each taking 60 min, at two levels, personal and interpersonal (for family members, health workers and healthcare givers). Finally, there was a three-month follow-up held in December 2021. RESULTS: After the training, a statistically significant difference was found between the IG and CG in all model constructs (p < 0.001). Before the intervention, in the IG, the personal health score was 4.35 ± 2.52, which was increased to 5.25 ± 0.753 after the training (p < 0.001). However, in the CG, the difference was not statistically significant (p < 0.030). 63.4% of women in the IG and 32.7% in the CG performed the CCS and the between-group difference was statistically significant (p < 0.001). Attitude, enabling factors and behavioral intention were the main predictors of CCS. CONCLUSION: The present findings showed though the training intervention based on the BASNEF model had limited resources and was run in a short time, it managed to motivate women to perform the CCS. It could maximally remove barriers at both personal and interpersonal levels and suggest strategies in the light of these barriers to achieve a successful screening program.

Cervical cancer is the fourth most prevalent fatal cancer among women on a global scale, and is one of the few cancers that can be prevented through screening. The high mortality rate of cervical cancer in developing countries, including Iran, has been largely attributed to inefficient screening programs. In developing countries cervical cancer screening programs are far from qualified. Yet, theory-based educational interventions can play an important role in promoting CCS behavior. Therefore, the present study was designed to determine the effect of an educational intervention based on the Beliefs, Attitudes, Subjective Norms and Enabling Factors (BASNEF model on increasing CCS in women in the south of Iran. BASNEF model includes beliefs about behavioral outcomes, attitudes toward behavior, subjective norms and enabling factors. The most significant construct in BASNEF model is the behavior change. Beliefs and attitudes are influenced by culture, values, traditions, education, media, and personal experiences. Subjective norms include family, society, social media, and peer pressure. Enabling factors include income, women's status, time, and skills. This model can be proposed as a new educational method. A quasi-experimental two-group (pretest­posttest) study was conducted in 2019­2020 on 202 women (101 in the intervention group, and 101 in the control group). In the intervention group, 14 training sessions (10 at the personal level and 4 at the interpersonal level) were held between 40 and 60 min' long. In the control group, 1 training session was held in 6 groups of 15­20. It was 60 min' long. The follow-up was held three months after the intervention. The results showed that the educational intervention, by affecting the BASNEF constructs, significantly affected women's CCS behavior. Maximizing barriers at both personal and interpersonal levels and suggesting strategies based on these barriers can help achieve a successful screening program. In particular, we call for the implementation of goal-oriented training programs according to health education and health promotion models to increase the rate of CCS behavior.

COVID-19 and hookah smoking cessation among women in Southern Iran: A cross-sectional study.

Hookah smoking does not only transmit COVID-19 but also intensifies the symptoms of the disease. Thus, the present research aimed to explore the association between COVID-19 and hookah cessation among female smokers. The institutional-based cross-sectional study was conducted nine months after the onset of the COVID-19 pandemic. Face-to-face interviews were held between November 2020 and January 2021 to explore the pattern of hookah smoking among 561 female hookah smokers in Bandar Abbas in the south of Iran. The daily, weekly and monthly rates of hookah smoking showed a statistically significant decrease in the during COVID-19 era (p < .001). Thirteen percent of women managed to cease hookah smoking successfully during the pandemic. The odds ratio of hookah cessation was higher in single women (95% CI 1.09-5.23) as well as women with a high socioeconomic status (SES) (95% CI 4.28-24.01). It was also higher among women who initiated hookah smoking at an older age (95% CI 29-68) and among those with no hookah smoking family member (95% CI 301- 943). Fear of COVID-19 infection was the leading factor involved in hookah cessation or reduction. Entertainment was the leading barrier to successful hookah cessation behavior. It is believed that COVID-19 has directly and indirectly contributed to the reduced or ceased hookah smoking behavior. One of the reasons for the reduction of hookah smoking was the fear of aggravated symptoms and reasons for cessation included closure of coffee shops and removal of all hookahs from the city.

Vaginal misoprostol and intravenous oxytocin for success of termination in the second-trimester intrauterine fetal demise: A randomized controlled clinical trial.

AIM: To compare the success rate of vaginal misoprostol versus intravenous (IV) oxytocin in termination of pregnancy in the second trimester intrauterine fetal death (IUFD). METHODS: This was an open-label randomized controlled study for 106 women with second trimester IUFD. Patients were randomly divided into two groups: women given vaginal misoprostol (400 mcg every 6 h up to 48 h) versus those given IV oxytocin (starting with 50 units up to a maximum of 300 units). When the first-line treatment (as mentioned above) failed, treatment methods were replaced with each other. When the second-line treatment failed, the patients underwent dilation and evacuation. RESULTS: The first-line treatment yielded the successful rate of 88.7% versus 73.7% for misoprostol versus oxytocin, respectively (p = 0.047). Among those with first-line treatment failure, the second-line treatment yielded success rate of 85.7% versus 83.3% for misoprostol versus oxytocin (p = 0.891). The mean duration of induction to delivery in women with successful response to first-line treatment was 28.72 and 20.55 h after initially receiving misoprostol versus oxytocin, respectively (p < 0.001). While during second-line treatment, this mean interval was not significantly different among those with misoprostol versus oxytocin (p = 0.128). No severe adverse events were observed. CONCLUSION: Vaginal misoprostol was associated with higher termination rate than oxytocin without adverse events when used as the first-line treatment. Both methods yielded the same success rate when used as the second-line treatment.

A predictive model of genital warts preventive behaviors among women in the south of Iran: application of health belief model.

BACKGROUND: Genital wart (GW) is known as an infectious disease. Besides the infection, it is associated with a higher risk of cervical neoplasia and cancer in the infected population. The present research aimed to explore the predictors of GW preventive behaviors based on the health belief model (HBM). METHODS: The present analytical and cross-sectional research was conducted in 2019 among 720 women between 15 and 49 years of age in Bandar Abbas in the south of Iran. The sample was selected in a multi-stratified clustering method. The participants responded to a reliable and valid researcher-made questionnaire which explored demographic information, knowledge-related items and the model constructs. A multivariate linear regression analysis was run to determine the predictors of adopting GW preventive behaviors. A path analysis was also run to test the direct and indirect effects of the model constructs on the dependent variable. RESULTS: The mean and standard deviation of participants' age was 30.43 ± 8.697 years. As Pearson's correlation coefficients showed, knowledge (r = 0.197, p < 0.001), perceived susceptibility (r = 0.434, p < 0.001), severity (r = 0.463, p < 0.001) and self-efficacy (r = 0.434, p < 0.001) were significantly correlated with the adoption of GWs preventive behaviors. Multiple linear regression analysis showed that self-efficacy (B = - 0.010, p < 0.001), perceived susceptibility (B = 0.070, p < 0.001) and severity (B = 0.078, p < 0.001) were the predictors of GW preventive behaviors. Path analysis showed that perceived susceptibility, severity and self-efficacy directly affected healthy behaviors while perceived benefits and barriers indirectly affected the preventive behaviors. CONCLUSIONS: The present findings help to promote knowledge of the predictors of GW preventive behaviors. HBM can be a useful theoretical framework to evaluate the preventive behavior of the disease and help to reduce the rate of sexually-transmitted infections including GW.

Comparison the efficacy of vaginal progesterone versus 17-alpha-hydroxyprogesterone caproate to prevent preterm birth in high-risk pregnant women undergo cerclage: a randomized clinical trial.

OBJECTIVE: The aim of this study was to compare the effect of vaginal progesterone with 17-alpha-hydroxyprogesterone caproate (17OHP-C) in prevention of preterm birth in high-risk pregnant women undergo cerclage. MATERIALS AND METHODS: This prospective randomized clinical trial registered in the Iranian Registry of Clinical Trials (IRCT20181107041585N4), was performed from May 2017 to August 2018 in Bandar Abbas, Iran. Fifty-eight eligible women who were scheduled for cervical cerclage due to a history of two or more previous preterm birth <28 weeks or a cervical length less than 25 mm with at least one previous preterm birth <34 weeks were randomly divided into two groups. The first group received 200 mg of vaginal progesterone suppository daily and the second one received 250 mg of 17OHP-C intramuscular weekly after cerclage procedure until the end of 36 weeks. Patients were followed up to the end of delivery and the newborn until the first 28 d after delivery. RESULTS: Gestational age at the time of birth in 17OHP-C group was significantly higher than vaginal progesterone group (p=.021). However, the incidence of preterm birth in both groups was not statistically significant (20.7% vs. 24.1%). Apgar scores, newborn birthweight, admission to neonatal intensive care unit (NICU), incidence of respiratory distress syndrome (RDS), sepsis, necrotizing enterocolitis (NEC), and, intraventricular hemorrhage (IVH), was similar in both groups. Adverse events were reported in 48.3% of patients in 17-OHP-C group, and 27.6% of patients in the vaginal progesterone group (p= .014). CONCLUSIONS: Vaginal progesterone and 17OHP-C had similar results in terms of prevention of preterm birth and neonatal outcome. However, the adverse events associated with 17-OHP-C were higher than vaginal progesterone.

The effectiveness of a model-based health education program on genital warts preventive behaviors: a quasi-experimental study.

BACKGROUND: Genital warts (GWs) are highly prevalent among Iranian women. GWs are not only highly infectious but are also followed by severe adverse effects, including the development of cervical cancer. Therefore, the present study aimed to explore the effect of an educational intervention based on the health belief model (HBM) on the adoption of GWs preventive behaviors by married women in Bandar Abbas, a city in the south of Iran. METHODS: A quasi-experimental intervention was conducted between 2019 and 2020 among 150 women participants (75 as the intervention and 75 as the control group). The sampling method was multi-stage clustering. The required data was collected using a reliable and valid tripartite questionnaire which explored demographic information, awareness, and HBM constructs. A total number of 15 educational sessions were held, each 90 min long. The control group received only one 90-min session. The final follow-up was completed three months after the intervention in November 2020. RESULTS: The two research groups had no statistically significant differences in terms of awareness, perceived susceptibility, severity, benefits, barriers, and self-efficacy before the intervention (in the pre-test) (p > .05). After the educational intervention, the two groups showed statistically significant differences in all constructs except for the perceived benefits (p < .001). In the intervention group, in the pretest (before the intervention), the behavior score was 2.77 ± 2.59, which was increased to 3.73 ± .52 after the intervention (p < .001). In the control group, however, the difference was not statistically significant (p = 0.227). CONCLUSION: The present findings showed that the educational intervention based on the HBM can improve the prevalence of GWs preventive behaviors in women. This education should be provided by experts at regular intervals in all healthcare centers.

Maternal predictive factors for preterm birth: A case-control study in Southern Iran.

BACKGROUND: Preterm birth (PTB) is one of the most important factors that increase the risk of chronic diseases and postpartum death in infants. The aim of this study was to determine the maternal factors that affect the birth of preterm infants in the city of Bandar Abbas. MATERIALS AND METHODS: This is a case-control study that was performed on 400 preterm infants. Sampling was done by a simple method, and information was gathered by interviewing the mothers and their medical records. Data were collected by SPSS software version 16. To compare risk factors in the two groups, conditional logistic regression was used, and P < 0.05 was considered statistically significant. RESULTS: Results showed that factors such as type of delivery (odds ratio [OR] = 3.584, 95% confidence interval [CI]: 1.981-6.485), preeclampsia (OR = 2.688, 95% CI: 1.164-6.207), history of PTB (OR = 4.171, 95% CI: 1.483-11.728), premature rupture of membranes (OR = 3.273, 95% CI: 1.745-6.137), care during prenatal (OR = 0.334, 95% CI: 0.159-0.701), placental abruption (OR = 3.209, 95% CI: 1.209-8.519), placenta previa (OR = 9.333, 95% CI: 2.086-41.770), and cervical insufficiency (OR = 11, 95% CI: 1.381-87.641) were independent risk factors of preterm infant birth. CONCLUSIONS: The PTB risk is higher for women with cervical insufficiency, history of placenta previa, and history of preterm. Early recognition and management of these high-risk conditions among pregnant women may lead to a reduction in PTB rates.

Vaginal misoprostol versus intracervical Foley catheter for cervical ripening in postdate primigravid women: a randomized clinical trial.

BACKGROUND: Being one of the most common indications of labor induction, postdate pregnancy can lead to serious maternal and fetal complications. In this study we aimed to compare vaginal misoprostol with intracervical Foley catheter (FC) for cervical ripening in postdate primigravid women. METHODS: This randomized clinical trial included 120 primigravid women aged 18-35 years with singleton,  postdate pregnancies, and Bishop score ≤ 4. Participants were randomized into two equal groups. The first group received 25 µg vaginal misoprostol and the second group had an 18 Fr FC inserted into their cervical canal. Labor induction was performed using oxytocin in both groups if progression of labor or true contractions did not occur within 6 h of the interventions. In case of nonreassuring fetal heart rate, fetal distress, placental abruption, or prolonged labor, C-section was performed. RESULTS: The frequency of normal vaginal delivery, Cesarean section, meconium-stained amniotic fluid, and neonatal intensive care unit admission did not differ significantly between groups. Placental abruption and uterine tachysystole occurred more frequently in the misoprostol group (15.0 vs. 1.7%, P = 0.008 and 21.7 vs. 0.0%, P < 0.001, respectively). A significantly higher number of women in the FC group required oxytocin (73.3 vs. 41.7%, P < 0.001). Duration of labor was significantly higher in the FC group (P = 0.001). CONCLUSIONS: Due to the lower rate of placental abruption and uterine tachysystole observed with FC, it appears to be superior to vaginal misoprostol for cervical ripening in postdate primigravid women; however, its longer labor duration and higher oxytocin requirement should be taken into consideration. TRIAL REGISTRATION: Iranian Registry of Clinical Trials, IRCT20181218042033N4 . Registered 19/04/2020. Retrospectively registered, https://www.irct.ir/trial/47037.

Association between self-efficacy and general health: a cross-sectional study of the nursing population.

BACKGROUND: The present research aimed to explore the association of self-efficacy and general health among nurses. METHODS: This was a descriptive-analytical. A total of 470 nurses were selected through the stratified sampling method. To collect the required data, GSE-10 and GHQ-28 were used. Independent-sample T-test, Pearson correlation coefficient, Chi-squared test, and regression were also used to analyze the obtained data. RESULTS: The results reveal a statistically significant correlation between general health and self-efficacy (t=-6.72, p < .001). Among general health parameters, social functioning has significantly predicted self-efficacy. CONCLUSIONS: As shown in the present findings, an acceptable level of self-efficacy can positively affect all aspects of nurses' general health.

The effect of aspirin on preeclampsia, intrauterine growth restriction and preterm delivery among healthy pregnancies with a history of preeclampsia.

BACKGROUND: Due to the significance of preeclampsia (PE) and its adverse outcomes in the health of both mother and newborn, the present study was carried out to investigate the effect of aspirin on preventing the occurrence of PE, intrauterine growth restriction (IUGR), and preterm delivery in women with a previous history of PE. METHODS: The present clinical trial was conducted on 90 pregnant women with a previous history of PE referred to the Khalij Fars Hospital in Bandar Abbas, Hormozgan Province Iran from April 2017 to August 2018. The subjects of the study were randomly assigned into two groups of intervention and control to receive either 80 mg of aspirin or placebo daily during the pregnancy. Patients' information was obtained and recorded upon entering the study, follow-up visits, and childbirth. RESULTS: Among participants who entered the clinical trial, 86 patients (95.6%) completed the study. During the pregnancy, systolic blood pressure increased by 8.25 ± 14.83 and 19.06 ± 18.33 mmHg in aspirin and placebo groups, respectively (p = 0.001). Also, the same happened with diastolic blood pressure (6.12 ± 11.46 vs 13.48 ± 13.95 mmHg, p = 0.010). The rate of PE was equal to 27 (62.8%) and 38 (88.4%) in the aspirin and placebo groups, respectively (aOR = 0.23, p = 0.013). In the aspirin group, the rate of IUGR was equal to 27.9% compared with 25.6% of newborns in the control group (aOR = 1.18, p = 0.750). Similarly, there was no significant difference in the rate of preterm delivery between the two groups (p = 0.061). CONCLUSION: The findings of the present study conducted exclusively on women with previous documented PE revealed that taking aspirin may have a preventive effect on PE in the current pregnancy.

A Population-based Prospective Study to Identify Contributors to Mother and Child Health in Suburban Communities: The Cohort Profile.

BACKGROUND: Following community health assessment Project (CHAP) in suburbs of Bandar Abbas city, health problems in women and children such as pregnancy complications and infant/child impaired growth are highly prevalent. Therefore, the present population-based prospective cohort study investigated the effects of a wide range of modifiable exposures during pregnancy and postpartum on mother and child health. METHODS: The sample comprised of 1000 pregnant women in their first gestational trimester, who live in the three most socially and economically vulnerable neighborhoods of Bandar Abbas, are under recruitment during Feb 2016-18. Four structured questionnaires are being carried out from pregnancy to 30 d, 6 months, and 12 months postpartum. Biologic and ultrasound results are also gathered through hospital and health center records. The study is currently close to the end of the recruitment phase. CONCLUSION: The results of the interim and final analyses are being translated into applicable preventive action plans aiming to reduce and control modifiable risk factors for ill-health in mothers and children in suburb communities in South of Iran.

Factors involved in selecting the birth type among primiparous women.

BACKGROUND: Mortality and disability rates were reported to be respectively 2-3 and 5-10 times higher in C-sections compared to Vaginal delivery. OBJECTIVES: This study was aimed to explore the factors involved in selecting the birth type among primiparous women. METHODS: The present cross-sectional research was conducted on 220 primiparous women, who visited the health-care centers of Bandar Abbas. They were recruited in their first trimester of pregnancy with a simple randomized clustering method. Data were collected in a researcher-designed questionnaire. Its validity was confirmed by a panel of experts and reliability was tested and approved through the test-retest method. Mean, standard deviation, independent sample t-test, and Chi-squared tests for data analysis were done by SPSS 16. P < 0.05 was considered statistically significant. RESULTS: The mean age of the participants was 27.40 ± 6.07 years. The main barriers to the choice of vaginal delivery were the fear of pain and fear of vaginal area tears and ruptures, fear of injury to fetus, and doctor's recommendation. A statistically significant correlation was observed between the age, education, employment, income, awareness, and the reasons for preferring surgical childbirth. CONCLUSIONS: To reduce the rate of unnecessary cesarean sections (C-section), the following recommendations are suggested: Reducing fear of pain in expectant mothers, modifying wrong beliefs about the culture of natural childbirth, increasing awareness of fewer adverse effects of vaginal delivery including the vaginal tears if the mother abides by all midwife(s) instructions during the delivery procedure, providing educational courses for the necessary movements during the delivery, decreasing surgeons' payment for C-section, and increasing payment for natural childbirth and implementing barriers for optional delivery to reduce the C-section.

The effects of water-pipe smoking on birth weight: a population-based prospective cohort study in southern Iran.

OBJECTIVES: Consecutive community health assessments revealed that water-pipe smoking in women and impaired growth in children were among the main health concerns in suburban communities in southern Iran. The aim of the present study was to identify the effects of water-pipe smoking during pregnancy on birth weight. METHODS: Data from a population-based prospective cohort study of 714 singleton live pregnancies in the suburbs of Bandar Abbas in southern Iran in 2016-2018 were used in this study. Data about water-pipe smoking patterns and birth weight were collected by questionnaires during and after the pregnancy. Low birth weight (LBW) was defined as a birth weight below 2,500 g. Statistical analyses were performed using generalized linear models, and the results were presented in terms of relative risk (RR) and 95% confidence intervals (CI). RESULTS: Fifty (8.2%) of the study subjects smoked water-pipe. The adjusted risk of LBW increased 2-fold in water-pipe smokers (adjusted RR [aRR], 2.09; 95% CI, 1.18 to 3.71), and by 2.0% for each 1-year increase in the duration of water-pipe smoking (aRR, 1.02; 95% CI, 0.99 to 1.05). CONCLUSIONS: Our results showed that water-pipe smoking during pregnancy was an important risk factor for LBW in this population sample from southern Iran. The introduction of regulations onto prevent water-pipe smoking and the implementation of community health action plans aiming at empowering women and increasing women's knowledge and awareness regarding the health consequences of water-pipe smoking are proposed.

Pregnant Women's Health Literacy in the South of Iran.

Objective: Investigate the health literacy of pregnant women in the south of Iran. Materials and methods: The present descriptive-analytical study was conducted on 775 pregnant women in the south of Iran (including Boushehr, Ahvaz, Zahedan and Bandar Abbas cities) through the clustering sample selection method. The data were collected through the Test of Functional Health Literacy in Adults: TOFHLA, and were analyzed statistically via SPSS 16 through independent-sample t-test and ANOVA. Results: The average age of the subjects was 31.89 ± 7.54 years. The results indicated that 15.5% of the subjects had an inadequate level of health literacy; 41.7% had a border-line level of health literacy, and 42.8% had an adequate level of literacy. Significant correlations were found between each of these variables and the subjects' level of health literacy: education, age, occupation and care provision during pregnancy (p ˂ 0.05). The highest mean score of health literacy belonged to Ahvaz while the lowest belonged to Boushehr. Conclusion: According to the results, the health literacy level of pregnant women in the target geographical areas showed to be inadequate or on a border-line. Moreover, subjects' education, age and occupation showed to be significantly correlated with health literacy. Therefore, promoting pregnant women's health literacy through simplifying health-related information, use of audio-visual media, improving communicative skills among the health staff and mothers can be effective.

Effect of Maintenance Therapy with Isoxsuprine in the Prevention of Preterm Labor: Randomized controlled trial.

BACKGROUND: Isoxsuprine (Vasodilan) is a beta-adrenergic that directly affects the vascular smooth muscle and results in peripheral vascular dilation. Isoxsuprine relaxes the uterine smooth muscles and is used for treatment of pre-term labor and dysmenorrhea. Isoxsuprine is used extensively in hospitals and private clinics in Iran; however, few studies have reported its safety and efficacy in the prevention of pre-term labor. OBJECTIVE: The aim of this study was to assess the effect of maintenance therapy with oral isoxsuprine for the prevention of pre-term labor. METHODS: We undertook a blinded prospective randomized trial of 70 women with singleton pregnancies who presented in pre-term labor between 26 to 34 weeks of gestation. After arresting the contractions with intravenous magnesium sulfate, the patients were randomized into two groups, with the treatment group receiving oral isoxsuprine until 34 weeks of gestation. Response to treatment was assessed by the progression of the pregnancies in both groups. The data were analyzed using SPSS software. RESULTS: Our results showed that 14 (40%) of the patients in the case group and 12 (34.29%) of patients in the control group had pre-term births, and there was no significant difference between the two groups (P=0.621). Also four women (11.43%) in the case group and five women (14.29%) in the control group delivered before 34 weeks (P=0.721). CONCLUSION: Oral isoxsuprine was not effective as a maintenance treatment in preventing pre-term births or in delaying delivery until after 34 weeks. Larger studies are needed to identify the best treatment for pre-term labor.

The Reproductive Behavior of Families with Thalassemic Children in Hormozgan.

BACKGROUND: Thalassemic disorders are the most prevalent monogenic hereditary diseases around the world caused by decreased and altered synthesis or agenesis in one or more globin chains. Families who have a child with thalassemia major face a myriad of significant problems. Hormozgan province ranks second with thalassemic patients in Iran. Therefore, current research is aimed to analyze the reproductive behavior of such families in the southern province of Iran. METHODS: In this descriptive study 190 mothers of patients suffering from thalassemia major were included. The reproductive behavior of mothers was investigated by a questionnaire regarding the number of thalassemic infants born after their first child with thalassemia major. RESULTS: About 23% of these mothers had more than 1 child with major thalassemia. The findings showed that the reasons for conception among these mothers were to have a healthy child (64.2%) and to have a boy (20%). In about 92.6% of mothers CVS test was not performed. CONCLUSION: This study showed that awaring mothers and families regarding the prevention of birth of afflicted infants and provision of accessible diagnostic facilities can reduce the number of children with thalassemia major.

Role of soap and water in the treatment of wound dehiscence compared to normal saline plus povidone-iodine: A randomized clinical trial.

BACKGROUND: The incidence of cesarean section is increased. About 3-30% of the women who undergo cesarean experience surgical site infections (SSIs). Many methods, have been used to decrease the incidence of SSIs, but despite much effort, no definite efficacious method has been suggested. MATERIALS AND METHODS: In this parallel, single-blinded, randomized control trial, 56 women with post-surgical superficial wound dehiscence were divided into two groups in a 1:1 ratio. One group was irrigated with normal saline for irrigation and Firooz® baby soapand the other with normal saline for irrigation and povidone-iodine. Formation of granulation tissue was monitored in both groups. Also, the reason for surgery, length of wound dehiscence, and duration of hospitalization and wound union after were compared in both group's. RESULTS: The soap group patients were irrigated for 4.18 ± 1.96 days compared to 5.36 ± 2.83 days for the patients in povidone-iodine group (P = 0.414). The granulation tissue was formed after 3.88 ± 1.94 days in the soap group compared to 4.48 ± 2.92 days in the other group (P = 0.391), and the duration of hospitalization was 5.48 ± 2.04 days in the soap group compared to 6.3 ± 2.95 days in the other group (P = 0.423). So, no differences were observed between the two groups. CONCLUSION: It can be concluded since there is no difference between the results of two groups, irrigation with normal saline and soap is safe, easy and causes no harm or allergy compared with povidone iodine and normal saline.