Effect of infrared belt and hot water bag on labor pain intensity among primiparous: a randomized controlled trial.

BACKGROUND: Labor pain is complex, paradoxical and varied in every parturient woman. Management of labor pain has been a crucial component in maternity care. Heat therapy is one of the proposed method for labor pain relief. Infrared is one of the methods of heat therapy but there is any study in this regard. This study aimed to compare the effect of the infrared belt and hot water bag on the severity of pain in the first stage of labor among primiparous women. METHODS: In this clinical trial in the first stage of labor, 20-min cycles of heat therapy were conducted at the dilations of 4-5 and 6-7 cm in the intervention group 1 by an infrared belt and in the intervention group 2 by hot water bag, respectively. The control group received routine care. The severity of the pain was measured by the short-form McGill Pain Questionnaire. RESULTS: In total, 136 women consented to participate in this clinical trial study. The mean score of pain intensity was significantly lower in the two intervention groups compared to the control group (P < 0.001). The mean pain intensity was significantly lower in the infrared belt group than in the hot water bag group (P < 0.001). CONCLUSIONS: Based on these findings, heat therapy with an infrared belt reduced the severity of pain in the first stage of labor. The infrared belt could be used and recommended as a safe and effective pain relief in childbirth and maternity care. TRIAL REGISTRATION: This study was registered in the Iran Clinical Trial Center with the code of IRCT20190805044446N1 .

The effect of couple supportive counseling on self-efficacy in women with insulin-treated gestational diabetes: A randomized clinical trial.

BACKGROUND: Gestational diabetes is the most common medical complication and a common metabolic disorder during pregnancy. Increasing people's self-efficacy is one of the best ways to control this disease. As there is a lag of intervention in this regard, the purpose of this study was to determine the effect of couple supportive counseling on self-efficacy in women with insulin-treated gestational diabetes. MATERIALS AND METHODS: In this randomized clinical trial, 64 women with gestational diabetes who referred to diabetes clinic of Mashhad Ommolbanin Hospital were divided into intervention and control groups through block randomization during 2019. Their gestational age was in 26-30 weeks. For the couples in the intervention group, three couple supportive counseling session was held. Each session lasted 1 h and was held one time per week. The instruments were diabetes self-efficacy questionnaire, fasting and 2-h postprandial checklist and Cassidy social support, which were assessed before and 4 weeks after intervention in both groups. Data was analyzed by SPSS software version 25 through Mann-Whitney and Wilcoxon test. P values of < 0.05 were reported to be significant. RESULTS: In the preintervention, the diabetes self-efficacy score had no significant difference in the intervention (30/6 ± 38/50) and control groups (09/8 ± 56/51) (P = 515/0). However, in the postintervention, the diabetes self-efficacy score was significantly higher in the intervention group (58/6 ± 41/71) compared to the control group (15/7 ± 31/51) (P < 001/0). Also, before the intervention, there was no significant difference between the intervention (30/2 ± 72/10) and control group (87/1 ± 63/11) (P = 137/0) regarding social support. However, after the intervention, there was a significant difference between the intervention and control groups (879/0 ± 53/13, 03/2 ± 41/11, P < 0/001 respectively). Also, data analysis showed a significant correlation between self-efficacy and social support (r = 0.451, P < 0.001), self-efficacy and fasting blood sugar (P < 0.001, r = -0.577), and 2 h post prandial (r = -0.778, P < 0.001). CONCLUSION: Couple supportive counseling leads to increased self-efficacy and social support in pregnant women with gestational diabetes. Therefore, it is recommended to use this counseling as an effective method in the management of diabetic pregnant women during their prenatal care to have a healthier pregnancy.

Six Weeks Effects of Dynamic Neuromuscular Stabilization (DNS) Training in Obese Postpartum Women With Low Back Pain: A Randomized Controlled Trial.

BACKGROUND: The worldwide prevalence of obesity and low back pain (LBP) has recently dramatically increased and is mainly indicated among postpartum women, leading to a range of adverse health consequences. OBJECTIVE: This study aimed to investigate the effects of 6 weeks of Dynamic Neuromuscular Stabilization training (DNS) in obese postpartum women with LBP. METHOD: This was a pretest-posttest study design. The study was conducted with 40 obese postpartum women with LBP randomized to receive DNS (n = 20) or General Exercise (GE, n = 20) 6 times a week for 6 weeks. The data were gathered before and after the 6-week intervention. RESULTS: Forty participants completed the study (mean ± SD, age 29.30 ± 3.77 years; weight 88.10 ± 6.09 kg; height 165.40 ± 6.31 cm; and BMI, 32.19 ± 1.07 kg/m2). The overall group-by-time interaction was significant for Numeric Pain-Rating Scale, Modified Oswestry Disability Questionnaire, Fear-Avoidance Beliefs Questionnaire, Inspiration and Expiration Breath Hold Time, and Respiratory Rate outcomes. The global rating of change was significantly different between groups (p < .05). The rate of improvement was higher in the DNS group compared to the GE group in all 6 tests. CONCLUSION: The present study confirms that DNS is applicable in obese postpartum women with LBP and effectively improved NPRS, MODQ, FABQ, BHT, and RR. It is clinically suggested that DNS is imperative based on ideal ontogenetic patterns to attain optimal results for obese postpartum women with LBP.

The Effects of Herbal Medicines on Women Sexual Dysfunction: A Systematic Review.

BACKGROUND: Sexual health plays an important role in women's health and quality of life. Sexual health management is a prerequisite for physical and psychological health of women. Sexual desire, arousal, and orgasm are three factors of female sexual response. OBJECTIVES: This study aimed at the evaluation of the studies focusing on herbal medicine on women's sexual function and the assessment of its effectiveness. METHODS: So far, many different methods have been known for the treatment of female sexual dysfunction, however, none of them are not efficacious therapy. RESULTS: Generally, the use of herbal medicine is a safe and effective therapeutic method in the treatment of women with sexual dysfunction. CONCLUSION: The role of herbal and nutritional supplementation in female sexual function has attracted researchers' interest in recent years.

Effect of Perineal Massage on the Rate of Episiotomy.

Objective: Women frequently experience perineal damage after a vaginal delivery. This study aimed to investigate the effect of perineal massage (PM) during labor on the need for episiotomies. Materials and methods: The study is a double-blind randomized clinical trial conducted with 99 patients (n=49 controls; n=50 cases). Participants comprised of nulliparous pregnant women aged from 18 to 35 years in the 37th-42nd week of gestation, who referred to the Um-al-Banin Hospital of Mashhad from July to October 2018, for vaginal delivery and were in the active stage of labor. Allocation to study groups was based on a random allocation list generated by a software application. PM was performed for the cases in the active stage four times, each lasting for two minutes at intervals of half an hour. The massage was continued at the beginning of the second stage of labor for ten minutes. Control women received routine care. The delivery was practiced by a midwife who was blinded to the study groups and the performance or non-performance of massage. Data were analyzed in SPSS software version 16. Results: The need for episiotomy was significantly lower in the PM group than in the control group (p = 0.05). Spontaneous perineal tears were significantly higher in mothers of the PM group (p = 0.05. The spontaneous tear degree in the 20 mothers who did not require episiotomy (p = 0.5) and the degree of perineal tear in mothers who needed an episiotomy (n = 79; p = 0.1) were not significantly different in the two groups. In the PM group members who did not require episiotomy (n = 14) and the mother underwent a spontaneous tear, first-degree tears were more frequent than second-degree ones. The median duration of the active stage of labor until the stage completion was lower in the PM group than in the control group, although the difference did not reach statistical significance (p = 0.3). The median of the second stage duration in the control and intervention groups were 55 and 45 minutes, respectively, where the difference was significant (p = 0.002), and the median time of completion of the active stage until delivery in the PM group had reduced. Conclusion: PM had a significant impact on the reduction of the need for episiotomies and the duration of the second stage of labor. Thus, it can be suggested as a safe, simple, low-cost, and effective technique to reduce the perineal damage during delivery.

Effects of a food product (based on Daucus carota) and education based on traditional Persian medicine on female sexual dysfunction: a randomized clinical trial.

BACKGROUND: Globally, female sexual dysfunction is a serious concern based on negative family and social consequences, high side effects of medications and lack of effective treatment. Thus, the evaluation of treatment approach for this problem is an important priority for healthcare systems. Sexual life and its related disorders are considered the main aspects of a healthy lifestyle in traditional Persian medicine (TPM). OBJECTIVE: The present study aimed to determine and compare the effects of food products containing Daucus carota, TPM-based training program, and a combination of these two interventions on the improvement of female sexual dysfunction. METHODS: This randomized clinical trial was conducted on 96 women with sexual dysfunction based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5®), aged 18-35 years who referred to the Gynecology Clinic of Mashhad University of Medical Sciences, Mashhad, Iran, during 2016 and 2017. The patients were randomly divided into three groups (n=32) and received the intervention over an eight-week period. The first group was provided with TPM-based sexual health training, the second group received 30 g of a traditional food product (wild carrot halva: mixed Daucus carota and several herbs with honey) on a daily basis, and the third group received a combination of this traditional food product plus education. Data analysis was performed using Chi square test, repeated measures ANOVA, two-way ANOVA, ANCOVA, post hoc Bonferroni, Friedman and Wilcoxon signed-rank test in SPSS version 11.5. RESULTS: According to the results of this study, there was a significant difference in terms of sexual desire (p=0.002), lubrication (p=0.002), orgasm (p=0.004) and pain (p<0.001) after eight weeks of the intervention among the three groups. CONCLUSION: The use of two interventions of TPM including a food product containing Daucus carota and this product with TPM-based education improved desire, arousal, lubrication, orgasm, satisfaction and pain in females with sexual dysfunction. Furthermore, TPM-based education alone, led to the improvement of all domains of sexual dysfunction, except for pain in the females with sexual dysfunction. TRIAL REGISTRATION: The trial was registered at the Iranian Registry of Clinical Trials with the IRCT ID: IRCT2015122425681N1). FUNDING: The present study was supported by a grant from the Research Council, Mashhad University of Medical Sciences, Mashhad, Iran (ref. no.: 941503).

Does maternal and fetal health locus of control predict self-care behaviors among women with gestational diabetes?

INTRODUCTION: Gestational diabetes is the most common metabolic disorder in pregnancy, and lack of self-care is the most important reason for mortality in diabetic patients. Since the glycemic control is associated with physiological and psychological mechanisms, variables such as health locus of control can play a role in health behaviors of diabetic patients. Therefore, this study was aimed to predict self-care behaviors among women with gestational diabetes based on maternal health locus of control (MHLC) and fetal health locus of control (FHLC). METHODS: This study is a descriptive, predictive correlational study that it is conducted on over 400 women with gestational diabetes attending the health centers and clinic of hospitals affiliated to Mashhad University of Medical Sciences in 2015. Data were collected using individual questionnaire, self-care derived from the summary of diabetes self-care activities, MHLC, and FHLC scale. The data were analyzed using Spearman's correlation coefficient test, linear regressions model, and multiple regression in SPSS software version 16. P < 0.05 was considered statistically significant. RESULTS: Results of Spearman's correlation coefficient test showed a significant direct linear relationship between self-care and internal MHLC (P = 0.027) and internal dimensions (P < 0.0001) and powerful others (P = 0.012) of FHLC. According to linear regressions model, internal MHLC (P = 0.027), internal dimensions (P < 0.0001), and powerful others (P = 0.012) of FHLC are considered as predictor variables of self-care. CONCLUSION: Midwives should perform interventions to increase internal locus of control and encourage more responsibility among women with gestational diabetes to achieve better self-care.

Comparing Formation or Non-Formation of Bladder Flap at Cesarean Section on Perioperative and Postoperative Complications: Double-Blind Clinical Trial.

Objective: To investigating formation or non-formation of bladder flap at Cesarean section on the complications during and after surgery. Materials and methods: This is a double-blind clinical trial study conducted during February 2014 to May 2015 on 64 pregnant women with gestational age of 36 weeks or more who were delivered by Cesarean section for the first time. They were randomly divided into two groups (intervention group: non-formation of bladder flap; control group: formation of bladder flap). The time to cut out the baby by Cesarean section, total duration of operation, bladder injury, intraoperative bleeding, hematocrit changes expected prior to during and following operation, postoperative pain, macroscopic and microscopic hematuria, postoperative complications and duration of hospitalization were compared between two groups. The data were analyzed with SPSS version 16 using and statistics tests. p < 0.05 was considered significant. Results: Time to cut out the baby for the intervention group (124.9 ± 40.5 seconds and for control group 155.1 ± 42.9 seconds) and total duration of the operation (intervention group: 27.7 ± 5.2 min and control group: 34 ± 4.73 min) were significantly different (p = 0.000). Number of gauze consumption during operation and postoperative hematocrit drop in the intervention group was significantly lower in the intervention group compared the control group (p = 0.000). The postoperative pain score in the intervention group (4.8 ± 1.1) and in control group (6.3 ± 0.9) were significantly different (p = 0.000). Conclusion: Omission of the bladder flap at Cesarean section leads to short-term benefits such as reducing the time to cut out the fetus, duration of surgery, decreasing postoperative bleeding and lowering pain.

Comparison of the effect of web-based, simulation-based, and conventional training on the accuracy of visual estimation of postpartum hemorrhage volume on midwifery students: A randomized clinical trial.

INTRODUCTION: Delay in diagnosis of bleeding can be due to underestimation of the actual amount of blood loss during delivery. Therefore, this research aimed to compare the efficacy of web-based, simulation-based, and conventional training on the accuracy of visual estimation of postpartum hemorrhage volume. MATERIALS AND METHODS: This three-group randomized clinical trial study was performed on 105 midwifery students in Mashhad School of Nursing and Midwifery in 2013. The samples were selected by the convenience method and were randomly divided into three groups of web-based, simulation-based, and conventional training. The three groups participated before and 1 week after the training course in eight station practical tests, then, the students of the web-based group were trained on-line for 1 week, the students of the simulation-based group were trained in the Clinical Skills Centre for 4 h, and the students of the conventional group were trained for 4 h presentation by researchers. The data gathering tool was a demographic questionnaire designed by the researchers and objective structured clinical examination. Data were analyzed by software version 11.5. RESULTS: The accuracy of visual estimation of postpartum hemorrhage volume after training increased significantly in the three groups at all stations (1, 2, 4, 5, 6 and 7 (P = 0.001), 8 (P = 0.027)) except station 3 (blood loss of 20 cc, P = 0.095), but the mean score of blood loss estimation after training did not significantly different between the three groups (P = 0.95). CONCLUSION: Training increased the accuracy of estimation of postpartum hemorrhage, but no significant difference was found among the three training groups. We can use web-based training as a substitute or supplement of training along with two other more common simulation and conventional methods.

The Effects of Ozonated Olive Oil and Clotrimazole Cream for Treatment of Vulvovaginal Candidiasis.

Context • Vulvovaginal candidiasis is the most common infection of the vulvovagina, which manifests with itching, a burning sensation, and leucorrhea. Some infections have been reported to be tolerant to conventional treatments, especially in immunosuppressed patients. New studies have suggested that ozone, which is the allotropic form of oxygen, may have antifungal effects. Objective • The study intended to compare the effects of ozononated olive oil and clotrimazole in the treatment of vulvovaginal candidiasis. Design • Patients were randomly assigned either to an ozone group or to a clotrimazole group in a randomized, controlled trial. Setting • The study took place in the Department of Gynecology of the School of Medicine at Mashhad University of Medical Sciences in Mashhad, Iran. Participants • Participants were 100 female patients who had been referred to the women's gynecology clinic at the Omolbanin and Ghaem Hospitals and who had confirmed vulvovaginal candidiasis. Intervention • Patients in the ozone group were treated with ozonated olive oil or those in the clotrimazole group were treated with clotrimazole for 7 d. Outcome Measures • Patients were evaluated through an interview and a paraclinical examination at baseline and postintervention. The study measured changes in itching, burning, and leucorrhea using a questionnaire that patients completed at the end of the study and determined the presence of an infection with vaginal candidiasis through a culture both before acceptance into the study and after the treatments, if accepted. Results • Ozone and clotrimazole both reduced symptoms significantly and led to a negative culture for vaginal candidiasis (P < .05). No significant differences existed between the 2 groups in their effects on the symptom of itching and leucorrhea and on the results of the culture (P > .05). However, clotrimazole decreased the burning sensation significantly more than did ozone (P < .05). Conclusions • Considering the potential efficacy of ozonated olive oil in the improvement of the clinical and paraclinical aspects of treatment of patients with vulvovaginal candidiasis, the research team suggests that the treatment can be an effective topical treatment for those patients.

Study on antiphospholipid/anticardioliplin antibodies in women with recurrent abortion.

BACKGROUND: Antiphospholipid antibodies are associated with recurrent abortion but correlation between level of antibodies and gestational age of abortion and duration post abortion is not clear. OBJECTIVES: Aim of this study was study on relation between antiphospholipid antibodies in women with recurrent abortion and their gestational age and duration post abortion. PATIENTS AND METHODS: We performed a case-control study on 197 pregnant women who had history of spontaneous recurrent abortion as case group and 50 pregnant healthy women as control group. Demographic characteristic of all participants filled in questionnaire forms. Antipospholipid and anticardiolipin antibodies were measured in their serum by Enzyme linked Immunoassay with orgenec kits. Data analyzed by SPSS software (version 13) and T statistical test. P value less than 0.05 was considered significant. RESULTS: Mean age of participants was 24-39 years old. The average rate of antiphospolipid antibodies in patients with normal anticardiolipin was greater than those with abnormal anticardiolipin and T-test showed significant difference between two groups.(P = 0.000) In case group the number of abortions was more, mean of antiphosopolipid antibody levels were also higher. Mean anticardiolipin and antiphospholipid antibodies rate was greater with increasing gestational age at time of first abortion. Almost mean antipospholipid and anticardiolipin antibodies in all patients remained in high level just in first 5 years with any number of abortions and five years later, antibodies began to fall. CONCLUSIONS: Antipospholipid antibodies based on number of abortions and gestational age of abortions were increased. Mean antipospholipid and anticardiolipin antibodies in all patients remained in high level just in first 5 years post abortion and then began to fall.

A Comparative Study of Relationship between Micronutrients and Gestational Diabetes.

In this paper, we studied the relation between the micronutrient and gestational diabetes. Therefore, we measured micronutrient concentration including Ni, Al, Cr, Mg, Fe, Zn, Cu, and Se in serum of women with gestational diabetes between 24 and 28 weeks of gestational age (study group) who had inclusion criteria and comparison with micronutrient levels in normal pregnant women with same gestational age (control group). Results showed that there was no significant difference between the serum micronutrient level (Ni, Al, Cr, Mg, Zn, Cu, Se) in study and control groups except serum level of iron which in serum of gestational diabetic women was lower than normal pregnant women and difference was significant.

Evaluation of group B Streptococci colonization rate in pregnant women and their newborn.

Group B Streptococcus (GBS) is one of the most important bacteria in the majority of maternal and neonatal infections, such as chorioamnionitis, endometritis, bacteremia, sepsis and meningitis. During pregnancy, GBS screening is one of the recommended strategies that are recommended by center of disease control (CDC). This study was aimed to determine the rectovaginal colonization prevalence among pregnant women, and also the rate of transmission to their offspring. Between June 2008 and April 2009, two hundred pregnant women admitted in department of Obstetrics and Gynecology (Ghaem Hospital, Mashhad, Iran) were enrolled in present study. Samples from maternal rectum and vagina as well as neonate ear and umbilical cord were taken for culture. The colonization rate for GBS in pregnant women and their neonates was around 6% and 5% respectively. All the carrier mothers were cases with premature rupture of membranes (at least 18 hours before delivery). In terms of colonization, there was a significant correlation between mothers and newborns, and more than 80% of neonates from GBS carrier mothers were colonized by GBS.

A comparative study of blood culture sampling from umbilical catheter line versus peripheral site.

Neonatal sepsis is an important cause of death and morbidity in newborns and is diagnosed by isolation of organism in blood culture. In several reports,reliability of blood cultures were done from umbilical catheters,have been demonstrated. The objective of the present study was to determine, wether an indewelling umbilical catheter, could be an alternative site for blood culture. In a prospective study over 6 months during 2006, 141 paired blood cultures from 134 infant,were done simultaneously from peripheral site and umbilical catheter (mostly U. V. C),during the first four days of life. Majority of these infants were preterm and admitted to NICU for special care. these infants had indwelling umbilical line and had indication of sepsis workup. A total of 141 pairs of blood cultures were obtained from 134 infants. In 16 infants blood culture pairs were positive for one organism in both peripheral vein and umbilical site. 71. 6% of total cultures (n=11) pairs were negative in both sites. A total of 22 pairs were positive in one site only,with 5 positive from peripheral vein only and the other 17 from umbilical site. Two pairs were positive in both sites with two different organism. In over all 16 infant (11%) of blood were considered to be contaminated. Contamination rate were 2. 4% and 9. 2% for peripheral and umbilical catheter site. Contamination rate increased after 48 hours of age in umbilical catheter. The result showed that after 2 days contamination rate for blood culture taken from catheter line increased and specificity decreased. We recommended that blood culture via umbilical catheter in first 2 days in sick neonates with indwelling catheter can be a alternate site of blood culture sampling.