Effectiveness of Dry Heat Versus Moist Heat Modalities on Pain Intensity and Wound Healing of Episiotomies Among Postnatal Women: A Systematic Review and Meta-Analysis.

OBJECTIVES: Comparison of the effects of dry heat versus moist heat therapy modalities on the intensity of pain and wound healing of episiotomies among postnatal women. DESIGN: A Systematic review and meta-analysis of controlled trials. DATA SOURCES: Six databases searched for original articles using relevant keywords until September 10, 2023, without time or language restrictions. REVIEW/ANALYSIS METHODS: All analyses employed Comprehensive Meta-Analysis (CMA) V.2. The measure of heterogeneity was computed using Cochran's Q-value. The I2 index was employed to quantitatively demonstrate heterogeneity. Statistical significance was reported for P-values <0.05 and I2>50%. RESULTS: Four quasi-experimental and three randomized controlled trials (RCTs) studies with moderate-to-good quality evidence met inclusion criteria. On the third to fifth day after the intervention in the dry heat group, the amount of pain was significantly lower than in the group that used moist heat [MD (95% CI) =-1.395 (-2.374, -0.416), P=0.005]. The use of a hair dryer significantly reduced pain (P=0.029), but an infrared lamp did not significantly reduce pain compared to moist heat (P=0.064). As compared to the moist heat group, the women using dry heat experienced better wound healing to the extent of 2.002 units of the REEDA (Redness, Edema, Ecchymosis, Discharge, Approximation) scale, which was statistically significant [MD (95% CI) = -2.002 (-2.785, -1.219), P<0.001]. CONCLUSION: Compared to sitz baths, dry heat reduced pain and improved episiotomy site healing in postnatal women. Therefore, dry heat, especially hair dryers, is suggested as a non-pharmacological strategy inside maternity hospitals, but additional targeted, high-quality trials are needed.

A Phenomenological Inquiry into the Psychological Experiences of Incarcerated Pregnant Women.

OBJECTIVE: With the increasing number of incarcerated women worldwide, the rate of women who experience pregnancy in prison, has also increased in this population. Exploring the unique experience of pregnant prisoners can contribute to understanding the complex world of this vulnerable population and, as a result, tailoring programs to promote their health status. The objective of this study was to understand the psychological experience of pregnancy in prison based on the lived experiences of incarcerated women. METHODS: This was a qualitative inquiry using van Manen's approach to phenomenology. Seven pregnant and four early postpartum women, with experience of pregnancy during incarceration, were selected purposefully in a prison in Iran from 2019 to 2020. In-depth semi-structured interviews were used to collect data. To analyze data, six-step van Manen's descriptive-interpretive phenomenological approach was adopted using MAXQDA10 software. RESULTS: The main theme of "white torture", a term used to describe the psychological and emotional distress experienced by incarcerated pregnant women, emerged from the data analysis. This theme echoes the pressure and torment of pregnancy on incarcerated women and consists of two subthemes: "captive to bitter and harsh emotions" and "suffering from psychosomatic pain and injuries." CONCLUSION FOR PRACTICE: As an emotional trauma, pregnancy puts incarcerated women under psychological torture. Policies should be developed towards the acknowledgment and meeting of the unique psychological needs of pregnant women in prison. It is also crucial for healthcare providers to provide women in prison with training on coping strategies to address the psychological and emotional challenges of pregnancy.

Motherhood Experiences of Incarcerated Pregnant Women: A Phenomenological Study.

Background: Motherhood in prison is a topic of growing importance and concern in the field of criminal justice. Incarcerated mothers face unique challenges that can have profound psychological impacts. The purpose of this study was to gain a deep understanding of pregnant prisoners' lived experiences of motherhood. Methods: This qualitative research was carried out using descriptive-interpretive phenomenology via interviews with 11 pregnant or early postpartum women in prison. The participants were purposefully selected from incarcerated pregnant women in a prison in Iran from 2019 to 2021. The MAXQDA software version 10 was used for data analysis, using Van Manen's six-step phenomenological approach. Results: The main theme of "living in a dichotomous world "consisting of two subthemes of "moving between unity and separation" and "being subject to ambiguity and uncertainty" emerged in this study. Motherhood in prison is just like living in a shaky and chaotic world, in which mothers are confused between reaching to and separating from their children. They are ambivalent about motherhood and experience mixed emotions of attachment and abandonment to their child and cannot be confident regarding the future of themselves and their children. Conclusion: Incarcerated mothers experience mixed emotions of attachment and abandonment towards their children, which leaves them uncertain about the future. It is recommended that security personnel of the prisons and families offer care and support to incarcerated mothers through constructive communications and empathy to enhance their well-being. It also seems crucial to adopt a community-centered approach that provides empathetic support and implements inclusive policies.

The effect of infertility counseling interventions on marital and sexual satisfaction of infertile couples: A systematic review and meta-analysis.

Background: Psychological consequences of infertility could have a negative effect on marital and sexual satisfaction. Numerous medical associations have strongly recommended psychological interventions, including counseling, to help infertile couples. Objective: This study reviewed the effectiveness of counseling interventions on marital and sexual satisfaction in infertile couples. Materials and Methods: This systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist Databases including PubMed, Web of Science, Psych Info, Cochran Library, Scopus, and Embase were searched for relevant articles published up to March 2020. All randomized clinical trials assessing the impact of psychological interventions on marital and sexual satisfaction in infertile couples were included in the review. The outcome measures were marital and sexual satisfaction, and the pooled estimate of the effects was calculated using a random-effects model. The risk of bias was measured using the Cochrane risk of bias tool, and the summary measures were reported as 95% confidence interval and percentage of heterogeneity. Results: Out of the 309 studies found through the search, 13 randomized clinical trials including 230 infertile women and 512 infertile couples were systematically reviewed and included in the meta-analysis. It was found that counseling interventions improve marital and sexual satisfaction. Conclusion: As counseling and psychological interventions increase the marital and sexual satisfaction of infertile couples, those are highly recommended for the psychological management of infertile couples.

The Needs of Incarcerated Pregnant Women: A Systematic Review of Literature.

BACKGROUND: With increase in the number of female prisoners, it seems necessary to follow up the conditions of pregnant women in prison in order to identify their needs and provide healthcare and social services to improve their health accordingly. Therefore, a systematic review was conducted to examine the needs of incarcerated pregnant women. METHODS: In this systematic review, we searched the databases including PubMed, Scopus, Web of Science, EMBASE, PsycINFO, and the Cochran Library. All studies including cross-sectional, retrospective, and prospective cohorts as well as case series, which addressed the needs and expectations of incarcerated pregnant women, were included in this review. Two reviewers independently evaluated the retrieved articles, the discrepancies were discussed, and a consensus was achieved. RESULTS: 31 eligible studies consisting of 5435 incarcerated pregnant women were included in the review. The needs of incarcerated pregnant women comprised six general categories: healthcare needs including prenatal, labor, delivery, and postpartum services; educational needs on pregnancy, childbirth, and parenting; the support needs to be provided by government agencies, social workers, and doula services; the need for psychological counseling services; nutritional needs during pregnancy; and the needs related to the substance abuse management. CONCLUSION: The needs of incarcerated pregnant women included healthcare, educational, supportive, counseling, and nutritional needs as well as those related to the substance abuse management. Identifying these needs can be useful in developing accurate and appropriate policies and programs to promote the health status of this vulnerable group.

Mortality of a postpartum woman presented with massive vulvar edema in association with Covid-19: a case report with clinical and radiological findings.

BACKGROUND: In this case report, we presented a rare case of maternal death with massive vulvar edema and Covid-19 diagnosis. CASE PRESENTATION: The case was a 20-year-old woman who was referred to with pain and massive vulvar edema by passing 7 days from her labor. The laboratory tests showed leukocytosis, lymphopenia, and elevated C-reactive protein levels. The high-resolution computed tomography was in favor of Covid-19 changes. Finally, she died because of respiratory distress, ON the 8th day postpartum. CONCLUSION: Given the increasing prevalence of Covid-19, it is important and vital to be aware of its potential complications and then to try prevent and manage them, especially during high-risk periods such as pregnancy and postpartum.

Promoting Health Care for Pregnant Women in Prison: A Review of International Guidelines.

BACKGROUND: There are standard guidelines for the provision of health care for pregnant women in prisons. There is no single guide to meet all the specific needs of imprisoned women. In this study, the related international guidelines were reviewed to reveal the existing gaps. MATERIALS AND METHODS: In this narrative review, studies published from May 2010 to January 2019 were reviewed through investigating databases including PubMed, Scopus, the Cochrane Library database as well as Science Direct Google Scholar using keywords: Guideline AND Prison AND Pregnancy AND Prenatal Care. The contents of the guidelines were subjected to analogy comparison. RESULTS: 13 guidelines were included in the study. Of these, 10 guidelines were related to the organizations deployed in the USA, two guidelines to the United Nations and the World Health Organization, and one guideline to the United Kingdom. The most comprehensive care coverage of pregnant women was suggested, at the first level, by Birth Champion and in the second level by the Federal Bureau of Prisons. The care recommended in the guidelines was classified into four general categories of health care, safety and security, education and counseling, as well as miscellaneous issues. Most of the care items mentioned in the guidelines were related to the issue of safety and security of pregnant women. CONCLUSIONS: There are currently gaps in the guidelines in many aspects including maternal and fetal health assessments, mental health care, and also ethical and communication issues. It is essential to upgrade the guidelines provided for imprisoned women to promote their health.

Compliance of Published Randomized Controlled Trials on the Effect of Physical Activity on Primary Dysmenorrhea with the Consortium's Integrated Report on Clinical Trials Statement: A Critical Appraisal of the Literature.

BACKGROUND: Randomized Controlled Trials (RCTs) are reliable methods for the evaluation of treatment effectiveness, which should be rigorous and must report with clarity. This study aimed to assess the compliance of published RCTs about the effect of physical activity on primary dysmenorrhea with the CONSORT 2017 statement. MATERIALS AND METHODS: In this study, the review of literature was carried out based on Consolidated Standards Of Reporting Trials (CONSORT). All the clinical trials focused on the effect of the physical activity on primary dysmenorrhea indexed in Web of Science, Pubmed, Scopus, Google Scholar, Science Direct, Embase, Magiran and Scientific Information Database (SID) were searched using keywords of dysmenorrhea, randomized clinical trial, physical activity and exercise from 2000 to 2019. Out of 1423 articles, 30 RCTs were critically appraised using CONSORT 2017 checklist. The reporting quality score of articles was identified between zero and 43. RESULTS: The compliance rate with the CONSORT checklist was 55.58%. The mean (SD) score of the reporting quality was 23.37 (-5.15) with a minimum of 16 and a maximum of 37. The maximum weakness was in reporting the sample size and full trial protocol 23.33% and 6.67% respectively. Regarding new items of the consort 2017, if the blinding was not possible, the description of any attempts to limit bias was not described in 70% of articles. CONCLUSIONS: Reporting sample size, trial protocol, method of blinding, and control of bias are issues that require more attention in reporting of RCT studies. We recommend that the authors use the CONSORT 2017 statement for conducting and reporting the clinical trials.

A Comparative Study of the Effects of Skin Contact and Kangaroo Care on Mother's Anxiety.

BACKGROUND: The aim of the study was to compare of mother and newborns abdominal contact and Kangaroo skin on mother's anxiety. MATERIALS AND METHODS: This study is a single-blind randomized control trial in 2015. Questionnaire about Demographic and Spielberger State-Trait Anxiety Inventory (STAI) was completed for two groups. RESULTS: There was no significant difference in maternal anxiety between kangaroo care and abdominal contact by Mann-Whitney test immediately after birth (Z = -1.33, p = 0.42) and after 2 months (Z = -1.47, p = 0.86). CONCLUSIONS: The effect of kangaroo contact on mother's anxiety was similar to abdominal contact and if the kangaroo care is done for a short period of time, it will not change maternal anxiety.

Evaluation of Factors Associated with Sexual Function in Infertile Women.

BACKGROUND: Infertility is a major and problem influencing different aspects of couples life, especially those of women. Sexual dysfunction is the silent partner of infertility. This study aimed to identify the above-mentioned factors to make necessary decisions and perform efficient interventions to improve the sexual health of infertile women. This study investigated the factors influencing sexual dysfunction in infertile women in Mashhad, Iran. MATERIALS AND METHODS: This cross-sectional study was conducted on 85 infertile women visiting governmental Infertility Clinic and Research Center in Mashhad, Iran. The convenience sampling method was used in this study. The research tools included a demographic and infertility information form, a sexual self-efficacy questionnaire based on Schwarzer's General Self-Efficacy Scale, Female Sexual Function Index (FSFI), and Evaluation and Nurturing Relationship Issues, Communication, and Happiness (ENRICH) Marital Satisfaction Scale. The descriptive statistical tests and logistic regression method were used to analyze data. RESULTS: The mean age of women was 31.18 ± 5.56 years old. The majority of participants (36.7%) had higher educations, and 60% of them were housewives. Most of their husbands (49.4%) were self-employed. The mean period of infertility awareness was 6.02 ± 4.47 years, and the mean period of infertility treatment was 4.11 ± 4.46 years. The following variables influenced the sexual function of infertile women: sexual self-efficacy, sexual satisfaction, marital satisfaction, the educational level of both wife and husband, income, satisfaction with spouse appearance, and the high costs of infertility treatment. CONCLUSION: The findings indicated that some factors such as sexual self-efficacy, marital satisfaction, sexual satisfaction, education, and cost of infertility treatment are associated with sexual function in infertile women.

Clinical application of 810nm diode laser to remove gingival hyperplasic lesion.

INTRODUCTION: Several treatment options have been introduced for removal of gingival hyperplasic lesions, but using diode lasers have many advantages such as less bleeding, time saving, better shaping, improved healing and less complication for the patients. CASE: A 15-year-old girl with multiple fibroma-like lesions in the oral cavity, who had a medical history of tuberous sclerosis, was selected for gingivoplasty treatment with 810nm diode laser. RESULT: A perfect shaping was obtained after removal of the whole lesion in one session and no recurrence was observed in 6 months. CONCLUSION: Using laser in the treatment of oral lesions leads to excellent wound healing along with excellent functional results.

Oro-facial manifestations of 100 leprosy patients

Objectives: To verify the frequency of oral and facial involvement in diagnosed leprosy patients. Study design: This study was performed on 100 leprosy patients (62 male, 38 female, mean ages 51.86±6.1). After explaining the study design, we studied descriptive information including: patient’s sex, age, job, place of birth, familial history of leprosy, types of disease (lepromatous, borderline and tuberculoid leprosy), ocular and oral lesions, facial involvement and neuropathy. The statistical signification was measured by chi-square test. Results: A total of 46 (23 lepromatous, 15 borderline, and 8 tuberculoid leproy) out of 100 patients with leprosy had oral lesions. Statistical analysis did not show any significant difference in frequency of oral lesions between different types of disease. Facial lesions were presented in 57 (39 lepromatous, 10 borderline, and 8 tuberculoid leprosy) patients. There was a statistical significant difference in frequency of facial manifestations between different types of leprosy. It has to be mentioned that, atrophy of nasal spine, facial nerve involvement, ocular lesions and facial deformity were seen in 15%, 17%, 22% and 44% of leprosy patients, respectively. Conclusion: Examination of leprosy patients should be extended to the oral mucosa because oral mucosa may be a secondary source of M.Leprae transmission and infection (AU)

Oro-facial manifestations of 100 leprosy patients.

OBJECTIVES: To verify the frequency of oral and facial involvement in diagnosed leprosy patients. STUDY DESIGN: This study was performed on 100 leprosy patients (62 male, 38 female, mean ages 51.86±6.1). After explaining the study design, we studied descriptive information including: patient' s sex, age, job, place of birth, familial history of leprosy, types of disease (lepromatous, borderline and tuberculoid leprosy), ocular and oral lesions, facial involvement and neuropathy. The statistical signification was measured by chi-square test. RESULTS: A total of 46 (23 lepromatous, 15 borderline, and 8 tuberculoid leprosy) out of 100 patients with leprosy had oral lesions. Statistical analysis did not show any significant difference in frequency of oral lesions between different types of disease. Facial lesions were presented in 57 (39 lepromatous, 10 borderline, and 8 tuberculoid leprosy) patients. There was a statistical significant difference in frequency of facial manifestations between different types of leprosy. It has to be mentioned that, atrophy of nasal spine, facial nerve involvement, ocular lesions and facial deformity were seen in 15%, 17%, 22% and 44% of leprosy patients, respectively. CONCLUSION: Examination of leprosy patients should be extended to the oral mucosa because oral mucosa may be a secondary source of M.Leprae transmission and infection.