Using Social Marketing to Reduce Intention of Cesarean Section in Iranian Women.

INTRODUCTION: In Iran, the rate of cesarean section is three times more than the acceptable rate considered by the World Health Organization. This study aimed at reducing the selection of cesarean section by primigravida through an intervention based on social marketing in Boyer-Ahmad County, Iran, 2015. METHODS: In this field trial, 39 of primigravida women were identified and selected as a target group. Formative research (a quantitative survey and a qualitative study) was done to achieve the social marketing mix. The tailored intervention was developed based on the findings of formative research. The intervention was implemented for one month for pregnant women who had cesarean section intention. Their intention for the cesarean section was studied again one month after the implementation of the intervention. The effectiveness of the intervention was evaluated by the proportion test. RESULTS: The average age of the women was 25.82. All of the women 38.5 percent had a diploma degree and lower than and 61.5 percent had a university degree. Before the intervention, 39 women intended to do Cesarean. The intention of 30 pregnant women was changed significantly one month after the intervention. CONCLUSION: The study showed the effectiveness of an intervention based on consumer-oriented social marketing theory and could be used to reduce Cesarean intention. More studies about related factors of vaginal delivery selection especially from behavioral intention up to behavior are suggested.

Women's Views About Domestic Violence: A Qualitative Study in Iran.

Violence against women is an urgent health priority in Iran. Designing effective programs for preventing and controlling the problem necessitates a thorough understanding of Iranian women and their perspectives regarding domestic violence. This study was aimed at exploring the domestic violence-related views of married women who were referred to health care facilities in Ahvaz, Iran. In this qualitative research, data were collected through four focus group discussions with 30 married women. All the discussions were recorded and transcribed, after which the data were classified separately. The main themes and subthemes were then manually derived from the data and analyzed. The five main themes identified were domestic violence against women in Ahvaz, behavioral influencing factors, nonbehavioral influencing factors, the necessity to empower women to prevent domestic violence, and recommendations for developing special training programs for Ahvazi women. Most of the participants were aware that domestic violence against women is a common occurrence in Iran. They were well aware of the definition of violence and expressed a belief that behavioral factors exert an important effect on the occurrence of the problem. They recommended the development of appropriate training programs that empower women to prevent the problem, the use of mass media to educate citizens about domestic violence, and the involvement of opinion leaders in eliminating the taboo against considering such violence a crime against Iranian women. Considering the views and ideas of women as consumers of educational services is a principle used to develop effective programs for preventing and controlling domestic violence. As indicated by the findings, the participants believe that empowering women must be treated as a priority in the Iranian health care system. However, they recommended differing approaches and methods of empowerment on the basis of their individual views and concerns.

Mothers' views about sexual health education for their adolescent daughters: a qualitative study.

BACKGROUND: Given that mothers play a role in the sexual education of their daughters, it is important to understand their views of sexual health and related programs. This study was aimed at exploring mothers' perspectives regarding sexual health education for their adolescent daughters in Mahshahr, Iran. METHODS: In this qualitative study, in-depth interviews with ten key informants and five focus group discussions involving 28 mothers with daughters aged 12-18 were conducted. All the discussions were audio-recorded and later transcribed. The data were classified, after which the main themes and sub-themes were manually extracted and analyzed. RESULTS: The five main themes determined were: the necessity of sexual health education for adolescent girls, the sources of information that mothers use, barriers to sexual health education, the need to empower mothers to provide sexual education to their daughters, and recommendations for developing special training programs for mothers. Most participants believed in limiting sexual health education for adolescent girls; nevertheless, they stated that trained mothers were best equipped to educate their daughters. The major barriers identified by the mothers were their own insufficient knowledge about sexual issues, embarrassment surrounding discussions of this issue with their daughters, fear of the arrogance and curiosity of girls, and a lack of skills for effective communication. CONCLUSION: The results showed that empowering mothers to provide sexual health education is important. Tailored educational programs, based on mothers' views, should be developed and implemented.

Effect of Nigella sativa on reproductive system in experimental menopause rat model.

OBJECTIVE: Menopause is the condition when regular menstrual periods cease and may be accompanied by psychological and physical symptoms. The purpose of current study was to determine Nigella sativa effects on reproductive system in experimental menopause animal models. MATERIALS AND METHODS: A series of experiments was conducted to investigate the effects of different dosages of N. sativa (first experiment), various extracts of N. sativa (second experiment) and some of its ingredients (third experiment) on selected menopausal parameters of ovariectomized (OVX) rats. Forty different OVX rats were equally divided into 5 groups and administered with one of the following treatments for 21 days: conjugated equine estrogen (positive control), distilled water or olive oil (negative control), treatment groups (N. sativa300, 600 and 1200 mg/kg in the first experiment), (300mg/kg methanol, hexane and SFE extracts of N. sativa in the second experiment) and (linoleic acid 50 mg/kg, gamma linolenic acid 10mg/kg, and thymoquinone 15mg/kg in the third experiment). RESULTS: The results demonstrated that N.sativa exert estrogenic effect were exhibited through uterotrophic assay and vaginal cell cornification as well as blood estrogen level. Furthermore, low dose N. sativa, methanol extract and linoleic acid had prominent estrogenic like effects which were significantly different from those of control group (p<0.05) in different experiments. CONCLUSION: The finding indicated the probable beneficial role for N. sativa in the treatment of postmenopausal symptoms and possibility of using N. sativa as an alternative to hormone replacement therapy (HRT) for post menopause in human.

Testicular morphology of male rats exposed to Phaleria macrocarpa (Mahkota dewa) aqueous extract.

OBJECTIVES: This study was designed to investigate the effect of Phaleria macrocarpa aqueous extract (PM) on spermatogenesis by observing the histological changes of testes in adult male rats. MATERIALS AND METHODS: PM was prepared by boiling the dried slices of P. macrocarpa fruits followed by filtering, centrifugation and freeze-drying to obtain the powder form. Eighteen Sprague Dawley adult male rats were divided into three groups (six in each group), designated as treatment (240 mg/kg PM), negative control (distilled water) and positive control (4mg/kg testosterone) and administered via intragastric gavage for seven weeks. In the sixth week of supplementation period, each male rat was introduced to five female rats. Afterward, all rats were sacrificed and the testes were removed for histological studies. RESULTS: PM significantly increased the number of cell and the thickness of seminiferous tubules of male rats (P<0.05). However, there was no significant effect on the volume and size of testes. The mean of spermatogonia cells numbers of PM groups differed significantly from the negative and positive groups (P<0.05). CONCLUSION: PM showed potential value as an attractive alternative for improving sexual strength by increasing the number of spermatogonia cell and the thickness of the seminiferous tubules. Perhaps, PM could be suggested to be one of the herbal remedies that can improve men fertility. The results may have some clinical implication in the management of infertility.

Effectiveness of selective vaginal tightening on sexual function among reproductive aged women in Iran with vaginal laxity: a quasi-experimental study.

AIM: Sexuality is an important part of women's health, quality of life and general well-being. Vaginal laxity may cause sexual dissatisfaction thereby causing some women to demand vaginal tightening surgeries. This study aimed to evaluate the sexual function preoperative and 6 months after selective vaginal tightening in women of reproductive age in Iran with vaginal laxity. METHODS: A quasi-experimental study was carried out on 79 women with vaginal laxity. All the women were requested to complete the questionnaire, which contained sociodemographic and Female Sexual Function Index (FSFI) questions preoperatively and 6 months after vaginal tightening. Data were analyzed using a paired Student's t-test, Wilcoxon rank sum test and Mann-Whitney U-test. RESULTS: The mean age of participants was 34.02 ± 5.30 years. The average total FSFI score increased from 24.19 ± 3.09 to 26.92 ± 3.41 (P < 0.001) after surgery. The scores for libido, arousal, orgasm and satisfaction domain were significantly improved, but a high level of dyspareunia and low vaginal lubrication were noted (P < 0.001). CONCLUSION: Sexual function was improved 6 months after vaginal tightening. This indicates that elective vaginal tightening had a positive effect on the sexual function in women. However, the increase in dyspareunia and decrease in lubrication may limit the application of this type of surgery. Further studies with longer follow-up are required to verify the long-term results of vaginal tightening.

Alternative supplement for enhancement of reproductive health and metabolic profile among perimenopausal women: a novel role of Nigella sativa.

OBJECTIVES: The aim of this open label crossover study was to investigate the effects of Nigella sativa on reproductive health and metabolic profile of perimenopausal women in Rawang, Malaysia. MATERIALS AND METHODS: Sixty nine perimenopausal women aged 45 to 65 were allocated into the experimental group treated orally with 1600mg/day of encapsulated pure powdered N. sativa compared to control groups treated with placebo for 12 weeks. At the end of study, participants underwent washout period for fourteen days before being crossed over and continued for another cycle of treatment. Participants were abstained from taking any other drugs, herbal preparations or food supplements throughout the study. Body weight, height, waist circumference, blood pressure, biochemical parameters and hormonal levels were measured at baseline and at the end of experiment for both cycles. Face to face interview was carried out at baseline and every week to check for compliance, minimize dropouts and to record reproductive health and quality of life indicators using Greene climacteric and SF-36 instruments. RESULTS: The treatment groups in both cycles showed significant improvement with reference to low density lipoprotein cholesterol and blood glucose (P<0.05). There were no significant differences between groups in total cholesterol, high density lipoprotein and triglyceride concentration. Treatment with N. sativa induced a significant reduction of prevalence and severity of menopausal symptomsas well as significant improvement in some components of quality of life (P<0.05). CONCLUSION: These results suggested that treatment with N. sativa exert a therapeutic and protective effect by modifying weight gain, improving lipid profile and blood glucose as well as hormonal level which is believed to play an important role in the pathogenesis of metabolic syndrome during menopause.

Supplementary health benefits of linoleic Acid by improvement of vaginal cornification of ovariectomized rats.

PURPOSE: This study aimed to evaluate the possible estrogenic activity of some ingredients of Nigella sativa including Linoleic acid and Gama-Linolenic acid by vaginal cornification assay. METHODS: Forty ovariectomized (OVX) rats, aged 16 weeks were allotted randomly to five groups: negative control (taking 1 ml olive oil/ day); positive control (taking 0.2 mg/kg/day Conjucated Equine Estrogen-CEE); experimental groups (taking 50 mg/kg/day Linoleic acid or 10 mg/kg/day Gamma Linolenic acid or 15mg/kg/day Thymoquinone ). All of supplements administered via intragastric gavage for 21 consecutive days. To assess estrogen like activity, vaginal smear was examined daily and serum estradiol was measured at baseline, after 10 days and at the end of experiment. RESULTS: The significant occurrence of vaginal cornification cell (p<0.05) after Linoleic acid supplementation indicated estrogenic activity of Linoleic acid which was in consistency with serum estradiol level, but this effect was not as much as CEE. Gama-Linolenic acid also exist a few cornified cell in smear which was not significantly differ from those control group. CONCLUSION: Linoleic acid showed the beneficial effects on OVX rats' reproductive performance, thereby indicating its beneficial role in the treatment of the postmenopausal symptoms.

Toxicity effect of nigella sativa on the liver function of rats.

PURPOSE: The aim of this study was to determine the toxic effect of Nigella sativa powder on the liver function which was evaluated by measuring liver enzymes and through histopathological examination of liver tissue. METHODS: Twenty four male Sprague Dawley rats were allotted randomly to four groups including: control (taking normal diet); low dose (supplemented with 0.01 g/kg/day Nigella sativa); normal dose (supplemented with 0.1 g/kg/day Nigella sativa) and high dose (supplemented with 1 g/kg/day Nigella sativa). All of supplements administered in powder form mixed with rats' pellet for 28 days. To assess liver toxicity, liver enzymes measurement and histological study were done at the end of supplementation. RESULTS: The finding revealed that there was no significant change in serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) between treatment groups. Histopathological study showed very minimal and mild changes in fatty degeneration in normal and high doses of Nigella sativa treated group. Inflammation and necrosis were absent. CONCLUSION: The study showed that supplementation of Nigella sativa up to the dose of 1 g/kg supplemented for a period of 28 days resulted no changes in liver enzymes level and did not cause any toxicity effect on the liver function.

Effect of Phaleria macrocarpa on Sperm Characteristics in Adult Rats.

PURPOSE: The purpose of this study was to determine the effects of Phaleria macrocarpa (PM) on male fertility by assessing its effect on the sperm characteristics which included the sperm count, motility, viability and morphology. METHODS: Eighteen male rats were equally divided into three groups. Each group of rats was orally supplemented for 7 weeks either with PM aqueous extract (240 mg/kg), distilled water (0 mg/kg) or testosterone hormone, Andriol® Testocaps™ (4 mg/kg) respectively. On the last day of supplementation period, the rats were sacrificed and sperm was obtained from cauda epididymis via orchidectomy. The sperm count, motility, viability and morphology were determined. RESULTS: PM aqueous extract significantly increased (p<0.05) the percentage of sperm viability. However, there was no significant effect of PM on the percentage of both sperm motility and morphology. The mean of body weight declined significantly in rats supplemented with PM aqueous extract compared to control groups (p<0.05). CONCLUSION: The results showed that PM significantly increased sperm viability without changing the sperm motility and morphology. Hence, this study suggests that PM offers an alternative way to improve male fertility by improving the sperm quality.

Effect of Nigella sativa on the kidney function in rats.

OBJECTIVES: Nigella sativa (N. sativa) is an amazing herb which is used in traditional medicine for a wide range of illnesses including bronchial asthma, dysentery, gastrointestinal problems, as well as beneficial effect on blood lipids, lowering blood pressure, serum cholesterol, and triglycerides level. This study aimed to determine the toxic effect of N. sativa powder on the kidney function which was evaluated by serum urea and creatinine and through histopathological examination of kidney tissue. METHODS AND MATERIALS: In this study, 24 male Sprague Dawley rats were randomly divided into four groups (six each). The rats were kept in the separate cage with three rats per cage. The treatment groups were given rat pellet containing N. sativa dose at 0.01, 0.10, and 1.00 g/kg body weight which were considered as low, normal, and high dose for five weeks while control group fed with rat chow pellet without supplementation. At the end of 35 days, the rats were sacrificed to take the blood sample and to remove the kidney organ for toxicity evaluation. Statistical analyses were done through one-way ANOVA using SPSS. RESULTS: The finding revealed that there was no significant difference in serum urea of treatment groups compared with the control group. The results showed a significant decline in serum creatinine of high dose of Nigella sativa treated compared with low dose treated and control groups (p<0.05). Histopathological examination of kidney tissue showed normal kidney architecture with no tissue degeneration, inflammation, necrosis, and tubular dilation in all groups. CONCLUSION: With the evidence of normal urea and creatinine level in blood and normal kidney tissue in histology examination for all treatment groups, it is suggested that there is no toxic effect on kidney function of Nigella sativa at different doses for five-week period.

Effect of Phaleria macrocarpa on sexual function of rats.

OBJECTIVES: The purpose of current study was to determine the effect of Phaleria macrocarpa (P. macrocarpa) fruits aqueous extract on reproductive performance of adult male rats by assessing the serum testosterone level and evaluating their libido behavior. METHODS AND MATERIALS: Eighteen male adult Spraque Dawley rats were divided into three groups and designated as treatment (240 mg/kg P. macrocarpa aqueous extract), negative control (distilled water), and positive control (4 mg/kg testosterone) which were supplemented through intragastric gavage for seven weeks. On the seventh week of supplementation, each of the male rats was introduced to five female rats at five different days to allow mating and observed the libido behavior. The mounting latency and mounting frequency were recorded for each mating. RESULTS: P. macrocarpa aqueous extract significantly increased (p<0.05) the serum testosterone level and mounting frequency of male rats. However, there was no significant effect on mounting latency. Body weight was significantly lower in rats supplemented with P. macrocarpa aqueous extract compared with the control groups (p<0.05). CONCLUSION: P. macrocarpa showed potential value as an alternative for improving the sexual strength by increasing the level of testosterone and libido behavior. Thus, it is suggested that P. macrocarpa can improve the fertility in man.

Pandemic influenza A (H1N1) and its prevention: a cross sectional study on patients' knowledge, attitude and practice among patients attending primary health care clinic in Kuala Lumpur, Malaysia.

The World Health Organization confirmed that the novel influenza A, H1N1 as a pandemic on 11 June 2009. After less than three months, 182 countries were affected by the pandemic accounting for about 150,000 infected cases and 3000 mortality. Successful H1N1 pandemic management strategies' shaped by making changes in health behavior. The aim of this study was to document patients' knowledge, attitudes and practices (KAP) regarding the pandemic influenza A (H1N1) and its prevention. We performed a cross-sectional study on knowledge, attitudes and practices (KAP) on preventive measures of Influenza A (H1N1) involving 322 patients attending Klinik Kesihatan Jinjang, a primary health care clinic in Kuala Lumpur, Malaysia from May 10 to 26, 2010 using a face to face interview with a structured pre-tested questionnaire. The majority of the respondents were females (56.8%), Malays (43.2%) aged between 18-27 years old (28.9%). There were significant association between knowledge on the complication of H1N1, effectiveness of the treatment, preventive measures of Influenza A (H1N1) and race (p<0.001) and educational level (p<0.001). There were also significant associations between attitude scores of these patients and their gender (p=0.03), and educational level (p=0.001). Practice scores related to H1N1 were found to be significantly associated with race (p<0.001) and educational level (p<0.001). The significant associations were observed between knowledge and attitude (p<0.001), knowledge and practices (p<0.001), as well as attitude and practices related to H1N1 (p<0.001). Knowledge has a crucial effect on patients' attitude and practice particularly in a pandemic spread. So health policy makers should attempt to disseminate information about preventive measures to community in order to improve their preventive practices during pandemics.

Impact of family planning health education on the knowledge and attitude among Yasoujian women.

The aim of this study was to determine the effect of health education on the knowledge and attitude regarding family planning and contraception's method among the women who obligatory attended the Premarital Counseling Center in Yasouj city, Iran. An experimental study was carried out and a total of 200 women were selected for the study using convenience sampling method among women who attended in the health centre in order to utilize the necessary premarital actions. Respondents were divided by two experimental and control groups randomly. A pre-evaluation was done on the knowledge and attitude on family planning using a structured questionnaire. After which, the health education for experimental group was done within four educational sessions during 4 consecutive weeks and control group underwent traditional education method. Post evaluation was utilized for any changes regarding their knowledge and attitude among the respondents immediately after the intervention. Independent and paired t-test was used to evaluate the mean knowledge and attitude scores differences among both groups. RESULTS showed that there was a significant improvement in respondents' knowledge and attitude after educational program in experimental group (p<0.001), while no significant difference was observed in knowledge and attitude of control group. The finding also indicated that age was significantly associated with the level of respondents' knowledge. These results deal the effectiveness of the educational method. In conclusion, the educational method is effective in increasing the knowledge and improving the attitude of women regarding family planning in Yasouj compared to current used educational method. Future educational programs need to incorporate the features that have been associated with successful interventions in the past, as well as including their own evaluation procedures.