شاداب شاه علی

Immigration could affect people's sexual health. The present study aimed to compare sexual quality of life of Afghan immigrant women living in Tehran province with Iranian women.

This was a cross-sectional study that conducted from August 2022 to March 2023, in health centers of three counties in Tehran province with a continence sample of 218 Iranian and 218 Afghan immigrant women who met the inclusion criteria. The data was collected by a questionnaire containing items on women's sexual quality of life and demographic characteristics, history of fertility and menstruation, use of modern methods of family planning, and frequency of intercourse with spouse per week. The descriptive analysis of the data included reporting of frequencies, mean and standard deviation. To investigate the factors affecting quality of sexual life, multiple linear regression model was used.

The results showed that the mean (SD) score of total sexual quality of life in Iranian women was 89.57 (17.34) and it was 81.40 (18.79) in Afghan immigrant women (P < 0.001). Age (P = 0.01), occupation (P < 0.001) and contraceptive method (P = 0.02) had an inverse and significant effect and education (P = 0.03), husband's occupation (P = 0.02) and number of sexual intercourses per week (P < 0. 001) had a significant direct effect on the sexual quality of life of Afghan immigrant women, and husband's occupation (P = 0.04), contraceptive method (P = 0.02), and number of sexual intercourses per week (P < 0.001) had a significant direct effect on the sexual quality of life of Iranian women.

Based on the findings, Iranian women had a higher sexual quality of life than Afghan immigrant women. These differences may be due to marginalization and lower education and cultural differences between Iranian and Afghan immigrant women. It is suggested that health centers provide sexual health promotion services for immigrant women.

Genital warts, in addition to being important as a sexually transmitted disease, can alter the emotional support of affected women and threaten couples' emotional relationships. This study was designed with a qualitative approach to investigate the challenges of emotional support for women with genital warts.

The present qualitative study was performed from January 2019 to February 2020 in the dermatology clinic of Razi Hospital in Tehran, Iran, with purposive sampling of 16 women with genital warts. Data were collected through unstructured interviews and analyzed using conventional content analysis approach.

After data analysis, a total of 182 codes, 8 subcategories, 3 main categories and 1 theme were obtained. The theme namely "Emotional Support Challenges" included the three main categories of "emotional relationship change", "disclosing the disease to seek support" and "worry for labeling and judgment".

The results of the present study showed the challenges of emotional support for women after contracting genital warts. After contracting genital warts, women experienced emotional deterioration. However, receiving emotional support from family members or friends instead of their partner accompanied by the worry of being judged and stigmatization.

Mobile health (mHealth) is an emerging technology with great potential for improving people's health. Due to its availability, this technology can create more motivation to improve women's health by providing safe, coordinated, and effective health care. Considering the importance of women's health, the present study was conducted to systematically investigate the impact of mHealth interventions on women's health outcomes.

The present study was conducted as a systematic review of clinical trial studies in English. PubMed, Scopus, Science Direct, the Cochrane Library, and ClinicalTrials.gov databases were reviewed according to the inclusion criteria from 2011 to 2021. 

A total of 28 articles were included in the study. mHealth tools, such as applications, text messages, voice or video calls, and wearable devices, were found to have multiple functions in this study, including providing information, reminders, education, and practical recommendations to improve the lifestyles of pregnant women in various areas. The study results indicated that in 82% of the studies, mHealth tools were effective in improving health outcomes for pregnant women, while in 18% of the studies, the intervention results did not differ from the standard method.

mHealth interventions can have a positive effect on improving the health of pregnant women, including their lifestyle, knowledge, and attitude regarding their own and their baby's health. However, in all these studies, high heterogeneity limits the certainty of the evidence for these findings. Therefore, future studies should identify the context in which mHealth can be more effective for women's health.

Women with physical disability face many unmet needs in receiving sexual health services. Variation in the sexual needs of these women may affect their care outcomes. This study was conducted with the aim of identifying clinical guidelines for providing sexual health services for women with physical disability.

This scoping review was designed and implemented with the 5-step approach of Arksey & O'Malley. Several databases (PubMed, Scopus, Web of science, Science Direct, G-I-N, NICE, AHRQ, WHO, UNFPA, Sid, Magiran) were searched to review articles and clinical guidelines in English and Persian according to the study inclusion criteria from 2006 to 2022.

Five clinical guidelines related to the provision of sexual health services for women with physical disability were identified from 23 screened. Using narrative synthesis of data four key themes were identified: 1) family planning services according to the severity of disability and prevention of unwanted pregnancy 2) diagnosis and treatment of genital infections and sexually transmitted diseases and AIDS 3) early detection of gender-based violence 4) counseling in the field of sexual problems

The clinical guidelines under review indicated sexual health services were provided for women with disabilities in the form of counseling, prevention and treatment service packages. However, quality of services was not considered in the reviewed guidelines. Therefore, due to the importance of the clinical approach in the sexual counseling of women with physical disability, the need to integrate the clinical guidelines available seems necessary.

Sexual assertiveness is defined as one of the most important components of sexual life and as a psychosocial feeling towards one's personal interpretation of how to express oneself in a marital relationship. The aim of this study was to investigate the relationship between sexual health literacy levels and Sexual assertiveness in married women of reproductive age.

This study was performed with a sample size of 200 married women in reproductive age who were referred to Banaruyeh health center in the south of Fars province, Iran through available sampling method. The instruments used in the study included a researcher-made demographic reproductive questionnaire, sexual health literacy for adults (SHELA) questionnaire, and the Sexual Assertiveness Hulbert. The data obtained from this study were analyzde through descriptive and inferential statistics using SPSS software version 21. 

The mean age of participants was 31.65 ±5.95 years. The   mean score sexual assertiveness was 58.9 ± 6.95. A quarter of women had excellent sexual health literacy. The results of analysis of covariance showed that people with inadequate, not enough and sufficient sexual health literacy levels had lower mean sexual assertiveness scores than those with excellent sexual health literacy levels (p˂0.05). There was a statistically significant relationship between sexual fulfillment score and occupation, spouse occupation, economic status and delivery history and between sexual assertiveness score with age, age of spouse, number of pregnancies, number of abortions, inverse and statistically significant relationship (p ˂0/05).

The results showed that higher levels of sexual health literacy were associated with higher scores of sexual assertiveness. Necessary educational and counseling interventions for women of reproductive age need to be designed and implemented to improve sexual health literacy.

Child growth health is one of the most important issues that determines the community health. Considering the importance of mothers in family and healthy society, the aim of this study was to evaluate the correlation between maternal employment status and infant growth during the 9-12 months in Ahwaz.

In this prospective cohort study, 345 nine-month infants of three groups of mothers including full time employees, part-time employees, and homemakers were selected using non-probability quotas sampling method. Data was collected using a researcher-made questionnaire and analyzed with the SPSS software version 22 using statistical tests such as chi-square, anova.

In the full-time job group, 54.2% of the infants had favorable weights and 45.8% had unfavorable weights. In the part-time group, 69.6% of the infants had favorable weights and 30.4% had unfavorable weights. In the homemaker group, 68.7% of the infants had favorable weights and 31.3% had unfavorable weights. There was a significant difference in the infant’s weight between full-time and part-time job groups
(P= 0.01) and the full-time job and homemaker group (P= 0.04) but there was no significant deference in the infant’s weight between the part-time job and homemaker group (P= 0.87). No significant association was found between maternal employment status and infant’s height (P= 0.11) and head circumference as well (0.08).

The growth status of infants with full-time working mothers was lower than that of infants with homemaker and part-time working mothers. It is recommended to reduce the working time of the mothers who have full-time jobs as long as they breastfeed their babies.

 Chronic Multiple Sclerosis (MS) often occurs in middle-aged people, who are supposed to take their most important roles in the family and community and thus affect their self-advocacy. This study aimed to identify the barriers to self-advocacy in women with MS.

This study was conducted using a qualitative content analysis method. The participants were 10 female members of the MS Association of Khuzestan Province of Iran aged 30-40 years with different educational levels, marital status, and occupations. They were selected using a purposive sampling method. The study data were collected through semi-structured interviews and continued until data saturation from June to November 2019. The content analysis was performed using Lundman and Graneheim’s qualitative content analysis method with an inductive approach conducted continuously and simultaneously with data collection. To evaluate the validity and reliability of qualitative data, we used Lincoln and Guba criteria (credibility, dependability, conformability, and transferability).

 The data analysis revealed 900 codes, 21 subcategories, and 6 themes of family barriers, medical barriers, job-related barriers, environmental barriers, sociocultural barriers, and psychological barriers.

 Women with MS face a variety of barriers to self-advocacy; most of them are related to family, environment, and society, in addition to personal barriers. Social support and the availability of sufficient and appropriate information about MS can play an important role in confronting these women with mentioned barriers and realizing their self-advocacy.

Diabetes is the most common medical complication of pregnancy. Identifying the new risk factor can help to early diagnosis of the disorder. CRP and Interleukin-6 are two inflammatory markers which can anticipate some pregnancy adverse complications. This study was performed with aim to assess the relationships between maternal serum CRP and Interleukin-6 (IL-6) at first trimester of pregnancy and gestational diabetes Mellitus (GDM) occurrence.

This descriptive-analytical cross-sectional study was performed in 2015-2016 on 500 pregnant women with gestational age < 14 weeks in Nilou laborator, Tehran. Serum levels of CRP, IL-6, fasting blood sugar (FBS) and lipid profile were measured. GDM screening was performed in 24-28 weeks of gestation. Data were analyzed by SPSS statistical software (version 21) and Kolmogorov-Smirnov, Chi-square, Mann-Whitney tests and Logistic regression model. P<0.05 was considered statistically significant.

GDM was found in 78 women (15.6%). Median CRP levels in GDM and non-GDM groups (4.8 vs. 5.22 mg/ml) (P=0.089) and median IL-6 (1.45 vs. 1.5 pg/ml) (P=0.574) was different, but the difference was not statistically significant. After adjusting the confounding variables in the logistic regression model, there were no statistically significant relations between serum level of CRP (OR=1.01, CI95%=0.96-1.07) (P=0.50) and IL-6 (OR=1.01, CI95%=0.89-1.46) (P=0.88) with GDM occurrence.

CRP and IL-6 levels are not significantly associated with the occurrence of GDM.

Dealing with a child with cerebral palsy (CP) is often accompanied by numerous limitations and troublesome parenting and long-term rehabilitation services may impose high pressure on parents. The therapists should understand the needs and expectations of parents to provide appropriate services to them. So, this study is conducted aiming to explore the experiences of parents of children with CP about therapists’ rehabilitation services in Ahvaz, Iran.

In this qualitative study, 10 parents of children with CP were selected through purposive sampling. Semi-structured interviews were used for data gathering. Interview questions were about the experience of parents about therapists’ rehabilitation services. The data were analyzed by qualitative content analysis through constant comparative method.

The data analysis led to a category named “characteristics of therapists providing rehabilitation services” that was divided into three subcategories including “clinical competency, adherence to professional duties, and adherence to professional ethics”. Clinical competency consisted of being scientifically certified, being experienced in the field, and masculine attitude and adherence to professional duties included parent training, understanding the parents’ conditions, and attention to parents’ therapeutic priorities. Finally, the adherence to professional ethics was comprised of consideration of ethical issues regarding children and parents.

Parents of children with CP stressed the need for therapists with clinical competencies, perform professional duties, and adhere to professional ethics. Therefore, therapists could provide better services through applying and implementing these principles.

Coronavirus 2019 is an emerging infectious disease. During an outbreak of infectious diseases, pregnant women and their fetuses are at high-risk populations. This study was performed with aim to investigate the maternal and neonatal consequences of pregnant women with COVID-19.

In this descriptive case-series study, all pregnant women referred to Tehran Amir Al-Momenin Hospital for delivery and were suspicious for COVID 19 were examined during March to May 2020. The subjects were sampled, and the maternal and neonatal complications diagnosed by clinical or laboratory symptoms were evaluated. Data were analyzed by SPSS software (version 21) and descriptive statistical methods (mean, standard deviation, number and percentage).

The most common symptom of COVID19 in 7 women (100%) in this study was fever. Only 2 women (28.57%) needed nasal oxygen after delivery, and none of the pregnant women needed assisted breathing device. All patients had high CRP and pulmonary involvement in CT scans. Five pregnant women delivered their infants by vaginal delivery, one of them was preterm labor and one infant had low birth weight. One male infant had asphyxia, and one male infant was dead 5 hours after birth, and two infants were hospitalized with symptoms of COVID 19, although their PCR tests were reported negative.

According to the results of the present study, COVID 19 is associated with maternal and neonatal complications.

The lack of accurate and timely sex education would endanger the physical and mental health of adolescents. Parents play an important role in the sexual education of adolescents, but they meet some challenges especially in Iran. The aim of this study was to describe the experiences and perceptions of parents' challenges of sexual education of male adolescents.

This qualitative study was conducted using content analysis method in 2016. Data were collected by semi-structured group interviews with 25 parents of 10-19-year-old adolescents who were living in Ahvaz and selected using purposive sampling method. Data were analyzed by qualitative content analysis.

After data analysis, 29 codes, 7 sub-themes (contradiction of parental views, parental confusion, barriers to communication with adolescents, the multiplicity and complexity of the sources of sexual information, cultural taboos, the lack of understanding of the need for sexual education, the missed role of school in sexual education) and one main theme (challenges of sexual education in male adolescents) were obtained.

The results of this study show that parents had inadequate skills in communicating with male adolescents, most of which derived from cultural taboos such as shame and hide and fear of breaking divorce between parents and adolescents. Therefore, the parental empowerment for the sexual education of adolescents with institutionalizing formal sexual education in the form of child-rearing practices is essential.

post term pregnancy is associated with maternal and fetal complications, including sudden death of the fetus and low Apgar score after birth. Evening primrose oil has been used for cervical ripening. Despite the effects of evening primrose oil on prostaglandin precursor levels and the well-established role of prostaglandins in the reconstruction of cervical matrix. This study was performed with aim to evaluate the effect of vaginal consumption of evening primrose oil on cervical ripening in nulliparous women with post-term pregnancy.

This randomized clinical trial study was conducted on 60 pregnant women with post-term pregnancy who referred to the maternity of Ahvaz Sina Hospital in 2017. The study groups consisted of 2 groups: vaginal capsule of 1000 mg of evening primrose oil and placebo. Drug was administered after induction of labor with 10 unit oxytocin. In the intervention group, one vaginal capsule of 1000 mg of evening primrose oil and in the control group, gelatin capsule as similar as the drug were used. Then, the induction of labor was started with oxytocin with similar dose (10 unit in 1000 cc serum ringer) in both groups. Cervical ripening was measured based on regular examination (every one hour). Data were collected by demographic questionnaire, timing, and bishop-score checklist. Data were analyzed by SPSS software (version 22) and independent t-test and Chi-square test. P<0.05 was considered statistically significant.

The duration of the latent phase in both groups was 9-10.5 hour. The duration of latent phase (p=0.003) and bishop score (p=0.01) had significant difference between the intervention group and the placebo group; it means more cervical ripening in the intervention group. At second stage of measurement, bishop score ≥7 was 90% in the intervention group and 60% in the control group that was significantly more in the intervention group (P=0.01). However, no significant difference between the two groups in terms of the duration of the active phase, progression rate, severity of pain, and volume of bleeding.

The vaginal use of evening primrose oil reduces the duration of the latent phase and has a positive effect on the cervical ripening and Bishop score

Identifying the challenges which exist in clinical education and along with setting to solve them will lead to improve the quality of medical care. Hence, this study was conducted to identify and assess the problems of clinical education model in Ahvaz Jundishapur University of Medical Science. In this descriptive–analytic research which was carried out in 2015-2016 second semester, All the last year midwifery students (n=48) through questionnaires that included five factors; environmental (7 options), performance of clinical instructors (6 options), preclinical education (4 options), health care personnel (4 options), clinical evaluation (3 options) were evaluated and data was analyzed using descriptive statistics. Also, with the nominal group technique which included all clinical educators (n=6), the most important challenges were determined. The weaknesses of clinical education from the viewpoint of students were indicated the lack of appropriate facilities, not belonging wage to midwifery students and the lack of ability to perform physiological vaginal delivery (100 percent). Moreover, from the viewpoints of Clinical educators were the lack of physical space and suitable facilities with 105 points, failing to provide feedback to the students along with practical work (70 points), Lack of coordination of training programs (60 points), the large number of midwifery students in each group(44 points) and disharmony of transportation service on holidays (30 points). Educational planners should continue to evaluate the challenges of clinical education and be adjusted to reinforce the strengths and also to moderate weaknesses of their efforts.

Stress urinary incontinence is a common problem among women, which negatively affects all aspects of a woman's life. This study was performed with aim to investigate the relationship between pelvic floor muscles’ strength and severity of urinary incontinence with quality of life in women with stress urinary incontinence.
This cross-sectional study was performed on 126 women with stress urinary incontinence in Ahvaz in 2015-2016. To determine the type of incontinence and its severity, the questionnaires of urinary incontinence (QUID) and urinary incontinence severity index were used. Pelvic floor muscle's strength was evaluated manually. The quality of life was measured using a questionnaire of measuring quality of life in women with urinary incontinence (IQOL). Data were analyzed using SPSS statistical software (version 22) and Chi-square test.
In this study, there is a significant relationship between the severity of urinary incontinence and muscle's strength with quality of life (p Women with more severe form of urinary incontinence and weaker pelvic floor muscles have lower quality of life, thus it is essential to consider the strategies to strengthen pelvic floor muscles and improve urinary tract health.

Victims of sexual assault require comprehensive, gender-sensitive health services in order to cope with the physical and mental health consequences of their experience. In most countries, however, there is a gap between the healthcare needs of victims of sexual violence and the existing level of health services provided in such cases. Experiences of the service providers help to deepen the understanding of this phenomenon; so, this study aimed to understand the perceptions and experiences of clinical health care providers to victims of sexual assault.

This was a qualitative study with content analysis approach. 23 healthcare providers working in private and public hospitals in Ahvaz and Tehran, Iran were selected with purposive sampling method. Data were collected using interviews, observations and recording field notes. All the interviews were recorded and transcribed verbatim. Data were analyzed using descriptive content analysis and the Granheim and Lundman method.

Five categories including 255 primary codes were emerged. The derived codes were as follows: 1) focus on the history and physical examination; 2) legal considerations; 3) diagnostic and para-clinical services;4) ostensible prevention and treatment of complications; and 5) consult and referral request. The main code included in all derived codes was "routine and task-orientation".

The findings showed that clinical healthcare providers provided health care to the victims of sexual violence regardless of their care needs, based on their routine administrative procedures. Therefore, the staff should concerns about the respond to the needs of females who have been sexually assaulted.

The purpose of the present study is to evaluate the effect of acupressure at the Sanyinjiao point (SP6) on the duration and pain of the active phase of labor in n ulliparas women. A single blind randomized clinical trial was performed on 120 eligible n ulliparas who were at the beginning of active phase of labor. The women were randomly assigned into two groups. The case group (n=60), received acupressure at Sanyinjiao point,(above the ankle), for 30 minutes during contractions. In the control group (n=60), simply a touch at this point without massage was performed. Two hours later a second pelvic examination was performed and in the absence of good forceful contractions oxytocin in the classical form was infused. Finally, the duration of active phase, severity of pain (using the Visual Analogue Scale, VAS), the amount of necessary oxytocin, and necessity to administer oxytocin, and the route of delivery were compared between both groups and statistical analysis was performed using SPSS 15. The mean duration of active phase was shorter in the case group (252.37±108.50 min vs 441.38 ± 155.88, P=0.0001). Six patients (10%) in the case group and 25 women (41.7%) in the control group delivered via cesarean section (P=0.0001). The severity of pain in the case group was less than the control group (5.87± 1.77 vs 6.79 ±1.52, P=0.003). Twenty five women (41.7%) in the case group and 38 women (63.3%) in the control group needed oxytocin (P=0.017), the amount of necessary oxytocin in the case group was less than the control group (73.33± 97.19 ml vs 126.6± 97.19 ml, P= 0.003). Acupressure at Sanyinjiao point (SP6) reduced the duration and severity of pain of the active phase of labor, cesarean section rates and necessity and amount of oxytocin.

Pneumothorax may be associated with penetrating or blunt chest trauma's that need early diagnosis and treatment. Today the diagnosis modalities are CXR and CT-Scan that are not suitable for unstable patients. Chest sonography can be a fast diagnostic method at patient bedside. The purpose of this study was to evaluate the accuracy of bedside ultrasonography in diagnosis of pneumothorax. In this prospective study, 60 cases suspicious of pneumothorax were included in study. Bedside ultrasonography was performed for all the cases. Sonography site was between parasternal and midclavicular lines in 2nd to 4th intercostals spaces of both thoracic sites and performed between 5-10 respiratory cycles. Gold standard results for definite diagnosis were: positive results of chest X ray, chest CT scan and/or air leak after needle or tube thoracostomy. In suspicious results, CT scan was done. Data were analyzed accordingly with statistic tests of “Chi-Square” and “Fisher’s Exact Test”. SPSS V.12 was also used. Trauma mechanism in 5 cases (8.3%) was stab wound, and in 53 cases(88.3%) multiple trauma; there was 1 case of tuberculosis and 1 case of blunt chest trauma as well. Eleven out of the 12 pneumothorax cases (proven by chest Xray or CT scan) were diagnosed by bedside sonography. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of bedside ultrasonography for diagnosis of pneumothorax were 91.6%, 100%, 100%, 97.9% and 98.6%, respectively. With respect to the results of this study and previous studies, bedside ultrasonography is a good method for diagnosis of pneumothorax.

Labor pain is considered as one of the most painful experience in women life so the reduction of pain of the active phase of labor is a very important issue. One way to reduce labor pain is acupressure. The purpose of the present study was to evaluate the effect of acupressure at the Sanyinjiao point (SP6) on the duration and pain of the active phase of labor in nulliparas women. A single blind randomized clinical trial was performed on 120 eligible nulliparas women (18-35 years old) who were at the beginning of active phase of labor and referred to Shahid Akbarabadi hospital, Tehran. The women were assigned into case group (n=60) and control group (n=60) one by one. The contractions and severity of pain controlled for 30 minutes in patients, the case group received acupressure at Sanyinjiao point, for 30 min during the pain and touch of this point occurred in control group. Finally, at the end of the active phase, severity of pain (with visual analog scale from 0 to 10), and the route of delivery were noted and compared between the two groups. There are significant differences between the mean duration of active phase in the control group (441.38±155.88) and case group (252.37±108.50) (p=0.0001), the kind of delivery (p=0.0001) and the severity of pain in the case group (5.87±1.77) and control group (6.79±1.52) (p = 0.003). The results of this study showed that acupressure at Sanyinjiao point (SP6) reduced the duration and severity of pain of the active phase of labor and cesarean section rates. So it's advisable to use this safe and ease way to reduce the labor pain.

Introduction & Stress urinary incontinence is a common problem among middle-aged women and can affect their quality of life. This study evaluated the effects of pelvic floor muscle exercise on quality of life outcomes in women with stress urinary incontinence. This clinical trial study was conducted at Shahid Akbarabadi Hospital of Tehran in 2009. After baseline evaluation, fifty women were assigned to this clinical trial. Participants were trained to do pelvic floor muscle exercises for 3 months and their quality of life were measured before and 3 months after intervention. The collected data were analyzed by the SPSS software using descriptive statistical tests and paired T experimental test. forty-six women completed the trial. After 12 weeks, the descriptive statistical tests and paired T experimental test showed significant difference in the quality of life scores of women with stress urinary incontinence before and after intervention(P<0.0001). 12 weeks exercise of pelvic floor muscle significantly improved the quality of life outcomes of women with stress urinary incontinence.

Neonates are more sensitive to pain and more susceptible to long term effects of pain than children and adults. Therefore, pain management has become a crucial part of neonatal care and cure. The aim of this study was to examine the effect of being in mother's hug and routine clinical procedure on neonates’ pain during immunization injections in health centers of west Tehran. This randomized controlled trial study was performed on 76 healthy term infants aged between 2-4 month, referred to the health centers of Iran University of Medical Sciences in west of Tehran for DPT immunization. One group were given in their mother's hug, 2 minutes before, during, and 15 seconds after the injection, and the other group were lied on the examining table according to routine of the clinic. Objective changes in appearance of neonates were assessed by Modified Behavioral Pain Scale (MBPS) from 5 second before immunization to 15 second after it. There was statistical significant difference between behavioral pain scores of the groups (P≤0.0001). Regarding�statistical�significant difference between behavioral pain responses of the groups, simple and safe practice of hugging infants by their mothers is suggested to reduce pain during immunization and muscular injections, too.

Since neonates have higher pain sensitivity, pain management has become a crucial part of neonatal care and cure. The objective of this study was to compare the effect of breast-sucking with being in the mother's hug on pain relieving during immunization injection. This controlled trial study was performed on 76 healthy term infants with 2-4 months years old. They were divided into two groups. By randomized collection one group were breast-fed, 2 minutes before, during, and 15 seconds after the injection, and second were in their mother's hug 2 minutes before, during, and 15 seconds after the injection. Modified Behavioral Pain Scale (MBPS) assessed objective changes in appearance of neonates (facial expression, cry and movements) during 5 second before immunization to 15 second after it. The scores for each behavior were calculated and compared in two groups. There were significant differences in behavioral pain scores of breast-fed group (4.6±1.8) and mother's hug (6.7±1.2) include facial expression (p=0.032), cry (p=0.0001) and movements (p=0.0001) and there is no statistically significant difference found between the 2 groups for age, sex and the time of feeding prior to vaccination. Breast-feeding may have an analgesic effect during immunization injections in healthy neonates.

Pain management is the challenging concepts in health workers. Since neonates have higher pain sensitivity in compare to childhood and adults. The objective of this study was to examine the pain relieving effect of breast feeding during immunization injections in healthy neonates. Methods and Materials: In this control randomized clinical trial, Samples were divided two groups (by age and sex) of 76 healthy 2- 4 months old term infants. In breast-fed group, 2 minutes before, during, and 15 seconds after the DPT immunization injection were in mother hug, and in control group as routine of clinic, were lied on the examining table during injection. Appearance of Neonates were observed and assessed by Modified Behavioral Pain Scale (MBPS) during 5 second before immunization to 15 second after it. In breast fed and control group mean of age were 81.53±41.46 and 81.61±40.59 day and for weight were 6.65±1.17 and 6.70±1.14 kg for hight were 64.27±5.5 and 63.38±5.06 cm respectively. There were significant differences in Behavioral Pain Scores of two groups include: facial expression (4 items), cry (5 items), and movements (6 items). (P<0.0001). There is no statistically significant difference between the 2 groups for age, sex and the time of feeding prior to vaccination Regarding to significant difference in behavioral of pain responds in two groups, it is suggested, with simple and safe intervention method of straight breast feeding reduce pain during immunization and muscular injections too.