فرزانه جعفرنژاد

Candidiasis is the second common vaginal infection, and commonly used drugs are azoles. Over-consumption of Azol is associated with resistance to drug and treatment failure. Studies conducted in vitro confirm the antifungal effects of coconut oil. The aim of this study was to compare the effect of vaginal cream of coconut oil and clotrimazole on vaginal candidiasis infection. This clinical trial study was performed on 71 women with Candida infection in two groups receiving vaginal cream of coconut oil: 35(78%) and clotrimazole (36%) (1%) who were treated for 7 nights (one applicator per night). One week after the completion of the treatment, patients were re-examined. Itching, burning, pain and secretion were compared in two groups. After the mean intervention (itching in the coconut group was 0±0 and in the clotrimazole group was 19±0.46 (p=0.017), (burning in the coconut group was 0.08±0.20 and in the clotrimazole group was 57% (p=0.046), (secretion in the coconut group was 0.05±0.23 and in the clotrimazole group was 66.6 ± 0.98 (p=0.001) (pain during sex in the coconut group 23 0.05 and 0.30±0.62 in the clotrimazole group (p=0.031). However, the success of the treatment (negative culture) was not significant between the two groups (p<0.05). The present study showed that vaginal cream of coconut oil and clotriamzole both improve vaginal candidiasis infection. Therefore, vaginal cream of coconut oil can be used as an alternative treatment for vaginal candidiasis

Premature rupture of membrane (PROM) is a common complication in midwifery and a serious consequence during pregnancy. This event can cause 18-20% prenatal mortality and 21.4% prenatal morbidity. Therefore, it is essential to use methods that can predict PROM. Regarding this, the purpose of the present study was to investigate the relationship between striae gravidarum and PROM among the primigravid women.
This predictive correlational study was conducted on 600 primigravidwomen with the gestational age of 35-37 weeks in Bojnourd, Iran. The study population was selected through convenience sampling technique. The participants were monitored and followed up until delivery, and thereafter divided into two groups of with PROM and without PROM. The data were collected using physical examination, interview, telephone follow ups, and patients’ medical records. In addition, the severity of striae gravidarum was determined by the Atwal scale. Data analysis was performed in SPSS (version 17) using descriptive statistics, Kolmogorov-Smirnov, Man-Whitney U test, Chi-square test, and logistic regression. P-value less than 0.05 was considered statistically significant.
According to the results, 445 (74.2%) participants had striae gravidarum, and PROM occurred in 22.3% of the cases (n=134). The results of the logistic regression test showed that the females with severe striae gravidarum were 2.617 times more prone to the incidence of PROM, compared to those without striae gravidarum (P=0.010).
According to the findings, the severity of striae gravidarum can be used as an indicator to predict the incidence of PROM. In order to prevent from such an event, the midwives and gynecologists can provide the mothers having severe striae gravidarum with proper recommendations in this regard.

The incidence of vaginal candidiasis and the number of treatment resistant cases are high; moreover, chemical medications are associated with serious adverse effects. Therefore, the use of herbal medicines is taken into consideration because they do not affect the normal vaginal flora and have low side effects. In vitro studies confirmed the favorable antifungal effects of coconut oil on various species of Candida, especially on the resistant species such as Candida glabrata and Candida tropicalis. This study was conducted to compare the effect of vaginally administered coconut oil and clotrimazole on Candida species.
This triple-blind clinical trial was conducted on 71 patients, who were assigned into two groups of coconut oil (35 individuals) and clotrimazole (36 individuals) in Mashhad, Iran, 2017. Data were collected using demographic data form and observation record sheets. The patients received the medicines by applicator for a week. Thereafter, physical examination and re-cultivation were carried out; and the success in the treatment included a negative culture and symptom relief. Data analysis was performed using independent samples t-test, Fisher’s exact and Chi-squared tests with the help of SPSS software, version 19. P-value less than 0.05 was considered statistically significant.
In this study, there was no significant difference between the groups in terms of the frequency of Candida albicans, glabrata, and tropicalis at the pre- and post-intervention phases (P=0.98, P=0.34, P=0.73, respectively). Regarding the success in the treatment, no significant difference was observed between the effects of vaginally administered coconut oil and clotrimazole on various species of Candida (P>0.05).
Considering the beneficial effects of vaginally administered coconut oil on candidiasis, it is recommended to use it to treat this disorder.

Premenstrual syndrome is experiencing of some physical and mental symptoms, and temperament can determine physical, psychological and emotional characteristics of the individual. Exercise is one of the treatments to reduce the symptoms of premenstrual syndrome. Therefore, this study was performed with aim to determine the prevalence of physical and mental symptoms of premenstrual syndrome after 8 weeks of regular aerobic exercise in warm and cold temperament.
This clinical trial study with two groups of control and intervention and with two subgroups of warm and cold temperament was performed on 70 students in dormitories of Mashhad University of Medical Sciences in 2014. The intervention group performed aerobic exercises for 8 weeks, 3 times weekly, and 30 minutes each session. The questionnaires which were used included: individual and midwifery characteristics, temporary diagnosis of syndrome, daily recording of syndrome symptoms, determination of the temperament, and Burg perceptual diagram. Using these questionnaires, the type of temperament, the severity of symptoms of premenstrual syndrome, and the effect of 8 weeks of aerobic exercise on symptoms of syndrome in two temperament were obtained. Data were analyzed by SPSS software (version 22), and descriptive statistics tests, Mann-Whitney, Chi-square and T-test. P In the intervention group in cold temperament, at the end of the study, all the physical and mental symptoms were less prevalent than the beginning of the study, so that the symptoms with severity of 3 had reached to zero; while in warm temperament, only confusion and worry had reached to zero, but all the physical symptoms and among the psychological symptoms, outbreak of anger, easy crying and tendency to be alone were less prevalent.
The prevalence of the severity of physical and psychological symptoms of premenstrual syndrome after 8 weeks of regular aerobic exercise was more improved in cold temperament than warm temperament

Bacterial Vaginosis is the most common cause of vaginitis that itself is responsible for 50% of all cases of vaginitis. Metronidazole is considered the first line for treatment, but it is reported that there is carcinogen and resistance to metronidazole. With regard to anti-bacterial effects of medicinal herbs such as Nigella sativa (the trade name of Phytovagex) on microbic organism, this study was done with aim to compare the remedial success percentage of Phytovagex vaginal suppository with Metronidazole oral tablet in women with bacterial vaginosis.
This triple-blind randomized clinical trial was done on 57 women with bacterial vaginosis referred to health centers subclass of health center No 2 in Mashhad at 2015-2016. The research units were randomly divided into intervention and control groups. The intervention group received Phytovagex vaginal suppository 1% once a day and placebo tablet twice a day for seven days, and control group received metronidazole tablet 250 mg twice a day and placebo vaginal suppository once a day for seven days. 7-10 days after treatment, the success percentage of treatment was investigated at each group by clinical standards. Data was analyzed by SPSS software (version 16) and independent t-test, Chi-square, Macnemar and Exact Fisher tests. P The success percentage of treatment of bacterial vaginosis was 74.2% in Phytovagex vaginal suppository group and 69.2% in Metronidazole tablet group that was not statistically significant (P>0.05).
Phytovagex vaginal suppository is as effective as Metronidazole tablet in treatment of bacterial vaginosis and can be an appropriate alternative to treat bacterial vaginosis.

Flaxseed, Evening Primrose Oil and Vitamin E are the first line treatment of Cyclic Mastalgia, but there is no evidence which reported that the impact of which one is more. So, this study was performed with aim to compare the effect of Flaxseed and Evening Primrose Oil with Vitamin E on the severity of Cyclic Mastalgia in women.
This clinical trial study was performed on 90 patient with Cyclic Mastalgia referred to gynecology clinic of Mashhad Ghaem hospital or the students living in dormitories of Mashhad University of Medical Sciences in 2015. Patients were randomly divided in to three 30 cases groups including Flaxseed group (30 mg daily powder of Flaxseed), Evening Primrose Oil capsule (2 1000mg capsules, daily) and Vitamin E (1 capsule of 400 IU, daily) for two menstrual period. The severity of mastalgia was measured through … at the baseline and end of every two interventional period. Data was analyzed by SPSS software (version 16) and Chi-square, Fridman, Fisher Exact, and ANOVA.
Median of the severity of mastalgia decreased in all three groups of Flaxseed, Evening Primrose Oil and Vitamin E after the intervention. But, three groups were not significantly different in the median of mastalgia before (P=0.779), one month (P=0.380) and two months after the intervention (P=0.764).
Use of Flaxseed, Evening Primrose Oil or Vitamin E lead to reduction in the severity of mastalgia and this reduction in all three groups is the same.

Premenstrual syndrome is one of the most common disorders in women of childbearing age, which is accompanied by periodic changes in physical, mental and behavioral condition. Exercise is one of the proposed therapies to reduce the symptoms of this syndrome. Based on principles of Traditional Persian medicine (PM), type and intensity of symptoms and effectiveness of exercise depend on patient's "temperament" (called “Mizaj” in Persian medicine). This study was carried out to determine the effect of aerobic exercise program on premenstrual syndrome in women of hot and cold temperaments.
This randomized controlled trial (RCT) was carried out on 65 students living in dormitory of Mashhad University of Medical Sciences. Students were divided into two subgroups of hot and cold temperaments using random allocation method. Participants of intervention group (of hot and cold temperaments) did 20-minute aerobic exercise 3 times per week for 8 weeks; no intervention was attempted in control group. The required information was gathered and analyzed using standard questionnaires on determination of temperament, temporary determination of premenstrual syndrome, Beck depression, daily record of premenstrual syndrome symptoms and Borg scale (IRCT: 2015021721116N1).
FINDINGS: The two groups were homogenous in terms of physical and mental symptoms, age, diet, grade and menstrual cycle characteristics. The results have demonstrated that after 8 weeks of aerobic exercise, physical symptoms of premenstrual syndrome among participants of hot temperament decreased from 21.8±2.5 to 10.4±3.1 (p=0.001) and decreased from 20.8±3.8 to 9.5±1.7 (p=0.001) among participants of cold temperament. Similarly, mental symptoms among participants of hot temperament decreased from 12.4±1.2 to 5.8±1.5 (p=0.001) and decreased from 11.9±1.9 to 5.3±1.2 (p=0.001) among participants of cold temperament and these changes were considered significant.
Results of the study revealed that doing aerobic exercise reduces the physical and mental symptoms of premenstrual syndrome among people of cold and hot temperament and highest level of symptom reduction was observed in participants of cold temperament.

Nigella sativa is one of the plants traditionally used in the treatment of dysmenorrhea, but its effect on menstrual hemorrhage has not been reported. Therefore, this study was performed with aim to compare the effects of Nigella sativa and mefenamic acid on menstrual hemorrhage.
This double-blind clinical trial was performed on 70 students with primary dysmenorrhea who were resident dormitories of in Mashhad University of Medical Sciences in 2014. The patients were randomly assigned to two groups of mefenamic acid and Nigella sativa. The research was conducted in two stages. At first, all the students were followed for two cycles in terms of bleeding, and then each of the patients randomly received Nigella sativa or mefenamic acid capsules for two consecutive cycles. Data were analyzed using SPSS software (version 16), and independent t-test and Friedman test. P Mean bleeding before the intervention in nigella sativa group was 85.20 ±37.85 cc that increased to 85.62 ± 34.2 in the first and to 85.77 ± 31.81 in the second cycle of treatment. Mean bleeding before the intervention in mefenamic acid group was 83.77 ±38.31 and decreased to 78.05 ±32.66 in the first and to 76.85 ± 29.71 in the second cycle of treatment. Overall, two groups were not statistically significant in terms of bleeding in the first and second cycle of treatment (P Use of Nigella sativa can increase the amount of menstrual bleeding, but this increase was not significantly different with mefenamic acid.

One of the psychosomatic problems which is associated with reproductive function and mood disorders is premenstrual syndrome. According to the theories of traditional medicine, person's temperament can determine physical, mental and emotional characteristics. Attitudes and mental status based on the theories of traditional medicine depends on person's temperament. This study was performed with aim to determine the relationship between warm and cold temperament with symptoms of premenstrual syndrome. This correlation and two groups (warm and cold temperament) study was performed on 65 students of the dormitory of Mashhad University of Medical Sciences for 2 months in 2014. Sampling method was easy non-random sampling. The tools included the questionnaire of selecting research units, the questionnaire of individual and midwifery characteristics, and standard questionnaires of determining the type of temperament, temporary determining of premenstrual syndrome, Beck depression, and daily recording of premenstrual syndrome symptoms. Data analysis was done with SPSS software (version 22), and Chi-square, t-test, and Mann-Whitney tests. P Among physical symptoms, two groups of warm and cold temperament were significantly different in terms of bloating (P=0.001), dizziness (P=0.0001), hot flashes (P=0.001), nausea-diarrhea-constipation (P=0.04), and increased appetite (P=0.03). Among psychological symptoms of premenstrual syndrome, two groups of warm and cold temperament were significantly different in terms of forgetfulness (P=0.001), irritability (P=0.04), over-sensitivity (P=0.01), and desire to loneliness (P=0.03). People with cold temperament who have premenstrual syndrome, the symptoms of syndrome is mostly in the form bloating, nausea-diarrhea-constipation, increased appetite, forgetfulness, irritability, desire to loneliness and in patients warm with temperament in the form of dizziness, flushing, and over-sensitivity.

Most primiparous women don’t have enough sense of competency، most of it being due to lack of experience. Maternal self efficacy-based training، have led to improved maternal-infant outcomes. : To determine the effect of self-efficacy education on maternal sense of competency of primiparous women in the infant care. In this clinical trial، 61 primiparous women were randomly divided into two groups. In the intervention group، an educational program was applied based on Bandura''s self-efficacy theory 10-15 days postpartum. The research instruments were parental expectations survey، Parenting Sense of Competence Scale، Perceived Social Support Scale، Infant Temperament، and Edinburg Depression Scale. Reliability and validity of the instruments were confirmed using the method of content validity and internal consistency. Data were analyzed using independent t-tests، Mann-Whitney U، paired t test and Wilcoxon. The mean age of the mothers was 24/4±3/2 years. The two groups were homogenous in terms of personal characteristics، although a significant difference was seen in terms of perceived social support (p<0. 05). Before the intervention، the mean score for maternal sense of competency was not statistically difference between the intervention (68/8±7/6) and control groups (66/7±7/9) (P=0/315). After the intervention، the difference between the mean score of maternal sense of competency in the intervention group (75/5±9/0) and control group (68/3±9/6) was statistically significant (p=0/004). Given the importance of self-efficacy improvement strategies in the improvement of maternal – child outcomes، application of self-efficacy resource can improve the sense of competency in motherhood.

Background and Pregnancy is a potentail window in a woman’s life where she can solve or mitigate her problems with doctors 's help. On the other hand, the structure of each healthcare system is set based on the specific services it provids. The type of healthcare structure can also influence the behavior of health care providers and quality of care provided. Therefore, this study aimed to assess the structure of preconception care in urban health centers, in Mashhad, Iran, 2012. This cross-sectional study was performed in 2012 among 22 health centers in Mashhad which were selected through multi-stage sampling. The Donabedian model was applied to collect the data. It included three sections on facilities, human resources, and orgnization. Data was analyzed in SPSS V. 16. The mean scores for the structures of the health care centers, facilities, human resources, and organization were 117.09±11.71, 67.45±10.22, 25.68±2.95, and 20.04±2.86, respectively. According to the results, enhancing human and organizational infrastructures in health centers could be of great help in providing beneficial healthcare.

Evaluation the factors associated with premenstrual syndrome creates a general approach to management of stress. The aim of this study was determining the relationship between stress and symptoms of premenstrual syndrome in students of Mashhad University of Medical Sciences. This cross sectional study was conducted on 115 student of Mashhad University of Medical Sciences in 2013. Sampling was randomly. Data were collected by Health-Promoting Lifestyle Profile II (HPLP2) questionnaire، a questionnaire of provisional diagnosis of premenstrual syndrome، and daily record form of symptoms of premenstrual syndrome. Data were analyzed using SPSS software version 16 and Spearman correlation coefficient، Mann-Whitney، t-test and Kruskal-Wallis tests. P value less than 0. 05 was considered significant. 65 students were suffering from premenstrual syndrome and severity of symptoms was mild in 24 cases (36. 9%)، moderate in 24 cases (36. 9%)، severe in 10 cases (15. 4%) and very sever in 7 students (10. 8%). The mean score of stress was significantly lower in student with non-premenstrual syndrome symptoms (p<0. 001). There was a direct significant correlation between stress scores and intensity of premenstrual syndrome symptoms in student with premenstrual syndrome symptoms (p<0/001). Students with less stress have lower premenstrual syndrome symptoms.

Prolapse of pelvis organs and urine incontinency are some factors can cause sexual complications. Surgical interventions like anterior and posterior colporrhaphy are common to resolve these complications. So، this study was done to determine the effect of colporrhaphy on sexual function and satisfaction. This retrospective cohort study was conducted on 100 women who were candidate for colporrhaphy in Mashhad’s state hospitals during 2009-2011. They were divided to groups. The first group underwent colporrhaphy in more than 6 months before and the other group was candidate for colporrhaphy. Two groups were asked to fill the questionnaires of demographic information، marital satisfaction scale، Pelvic Organ Prolapse /Urinary Incontinence Sexuale (PISQ)، Index of Sexual Satisfaction (ISS)، depression، anxiety and stress scale (DASS 21). In all sample units، operations were done in the same procedure. Data were analyzed using SPSS software version 18. P value less than 0. 05 was considered significant. There was a correlation between sexual satisfaction and colporrhaphy (p=0. 033)، as sexual satisfaction after surgery decreased by 18%. 16 women (32%) complained of dyspareunia and 25 women (50%) complained of vaginal stenosis after colporrhaphy. However، sexual function did not change after surgery (p=0. 189) and postoperative sexual function score of desire (p=0. 578)، arousal (p=0. 470) and orgasm (p=0. 408) had not significant differences with before surgery. Colporrhaphy decreased stress urinary incontinence (p=0. 000). Although colporrhaphy improves stress incontinence in women، but had no effects on sexual function and decreases sexual satisfaction. Colporrhaphy is better to be done only for curative purposes and in conditions such as severe and unbearable symptoms of prolapse and incontinency.

One of the most common causes of referal of women of childbearing age to physician is the cyclic mastalgia. The present study was performed due to the similar mechanism of action of fish oil and vitamin E in reducing this pain. To determine the effect of fish oil and vitamin E on duration of Cyclic mastalgia. This Triple-blind clinical trial was performed on 70 women (15 to 49 years) suffered from cyclical mastalgia. Patients were divided into two study groups with 35 patients in each group، included: 1. Fish oil 3gr/day، 2. Vitamin E 400 unit daily. Breast pain duration was evaluated before the study and 1 and 2 months after the intervention، In addition، medication side effects were assessed after an intervention. Data after collected by registration table of breast pain duration was analysed by SPSS statistical software (version16). Chi-square، repeated measures ANOVA، independent and paired-t tests were performed. The mean of breast pain duration in fish oil group before an intervention was 9/3±3/4 and was decreased to 2/5±4/5 2 months after the fish oil consumption. Also in Vitamin E group this mount decreased from 9/5±3/3 to2/2±3/5. Overally the mean scores of breast pain duration decreased before and after the intervention in both groups (P<0/001). According to the findings of this study and the absence of serious drug side effects، fish oil and Vitamin E with similar therapeutic effects in the treatment of cyclic mastalgia، can be a viable alternative to other hazardous drugs in this field.

Assessment the quality of prenatal care can determine current status and be aware of effectiveness of measures taken in order to improve the quality of cares. Donabedian model is a good model of care in the health care field. Based on Donabedian model، the process of care is an important part of the trend of providing and receiving services that can assessed in technical and interpersonal interactions parts. The aim of this study was to assess the situation of presented prenatal care based on Donabedian model. This descriptive study was conducted on 320 women who referred to health centers for taking prenatal care in Mashhad، Iran، 2012. Method of sampling was multi-stage. Data was collected using a questionnaire contain information of care providers and participants and an observation checklist based on Donabedian model that divided into two parts of technical and interpersonal interactions. Data were analyzed using SPSS software version 16، Kruskal-Wallis and Chi-square. P value less than 0. 05 was considered significant. The overall mean of the process of care was 47. 92±8. 70. Results of divided of care process into two parts technical performance and interaction interpersonal showed that the average scores of technical performance was 23. 2±4. 71 and the interaction interpersonal scores was 22. 76±5. 02. Results of the study showed that the status care providing process was intermediate in 93. 7% of cases. Given the current level of quality of care، increasing the number of care providers per population covered in health cares، sensitization of prenatal care and giving information seems to be necessary.

Dysmenorrhea is a common gynecologic disorder that affects 50 percent of women who have menstrual periods. This study investigated the effects of brisk walking on primary dysmenorrhea on girl students. In this clinical trial، 45 students of exercise group and 45 students of control group who were studied in faculty of nursing and midwifery were studied in Mashhad، Iran، 2012. Exercise group performed brisk walking for half an hour in the first 3 days of menstruation in three consecutive menstrual cycles. Research tools included visual pain scale، demographic data questionnaire and menstrual characteristics before and after exercise. Data were analyzed using SPSS software version 19، paired t-test، Mann-Whitney and Wilcoxon tests. P value less than 0. 05 was considered significant. The mean age of participants was 20. 74 years. The mean of dysmenorrhea duration of each cycle and days of bleeding were 2. 49 days and 6. 96 days، respectively. The mean of pain scores was similar in two groups before the intervention but it was significant after the intervention (p<0. 001). There was a significant difference in the exercise group in terms of pain severity before and after intervention (p<0. 001); while، there was no difference in the control group in this regard (p=0. 81). Brisk walking for half an hour in the first 3 days of menstruation reduces pain of primary dysmenorrhea.

Sexual issues have the greatest importance in a marriage. However، sexual dysfunction is one of the common and treatable problems، which causes emotional tensions and marital problems. The present study has pointed to the role of body mass index (BMI) on sexual function. This paper was held to determine the relationship between sexual function and obesity in women. This correlation study was performed on 286 eligible women that referred to health centers in Mashhad in 2011. The researcher settled at the intended health centers and interviewed the eligible individuals. Interview and observation forms were utilized for data collection. Data were analyzed by SPSS statistical software version 14. 5، descriptive، chi-square، Mann-Whitney and regression tests. P value less than 0. 05 was considered statistically significant. Self-image and life quality were statistically significantly different in the two groups، as well as، in main variables of sexual function including libido (p<0. 001)، arousal (p<0. 001)، lubrication (p<0. 001)، orgasm (p<0. 001)، sexual satisfaction (p<0. 001) and pain (p=0. 018). Positive self-image effects orgasm، arousal، lubrication and sexual satisfaction. An effective factor on libido is wife''s age and an effective factor on sexual satisfaction is one''s age. Obesity in women is associated with sexual dysfunction، impaired self-image، and reduction of life quality. Therefore، in order to enhance sexual performance، and improve quality of life and self-image، losing weight is mostly recommended obese women.

Although the majority of student assessments in medical sciences relates to their clinical competencies, adopting an assessment method which fulfills students’ satisfaction has always been a great challenge. In recent years logbooks have been used in the clinical evaluation of midwifery students in Mashhad University of Medical Sciences. So, the present study determines student's satisfaction with this approach. This descriptive, cross-sectional study was conducted on all 34 eligible midwifery students in school of nursing and midwifery of Mashhad University of Medical Sciences. Data gathering tool was a researcher–constructed questionnaire with confirmed validity and reliability. The questionnaire included 23 items covering nine domains and used Likert scale. Data were analyzed through descriptive statistical indices as well as T test, correlation and multiple regression analysis. The mean score for student's satisfaction with logbook was 62.7 ±15.5 (of 100). The lowest satisfaction score was related to the domain of "interest in logbook method" (57.8 ±24.5) and the highest one was "conformity to educational goals" (71.1 ±14.9) (of 100). Most of the students agreed that logbook is fair (55.9%), objective (64.7%) and in conformity with educational goals (61.8%). However, only 44.1% of them were interested in using this method. Overall, 38.3% of the students were satisfied with logbook and 26.5% were dissatisfied and the rest were in between. Most of the students were satisfied with logbook, but less than half of them were interested in utilizing it. This could be due to insufficient ability of logbook in assessment and promoting of clinical skills from the student's view point. Thus, we may improve the student's satisfaction level by revising logbook and combining it with some other methods of clinical evaluation in order to cover its weak aspects according to student's views.

Maternal attachment has the potential to affect both child development and parenting. As such, mother-infant attachment has been considered an important topic in recent years. The aim of this study was to determine the relationship between maternal adult attachment style, the maternal obstetric and demographic characteristics and mother-infant attachment. In this descriptive-correlational study, 102 women who had referred to health centers in Mashhad in 2008 and who had inclusion criteriawere selected using stratified cluster sampling. After interview about obstetric and demographic characteristics, they were asked to complete the "Revised Adult Attachment Scale" and "Mother to Infant Attachment Inventory" for assessment of maternal attachment style and mother-infant attachment 4-5 weeks after delivery. Data were analyzed by Pearson Correlation, Kruskal-wallis and Mann-whitney statistical tests. In this study, themean of mother-infant attachment was found to be 97.486.12 and the mean of secure adult attachment was higher than that of other styles (16.893.97). Although, there were negative significant relationship between maternal avoidant style and mother-infant attachment (p=0.037,r=-0/20), there were no relationship between maternal age and education, parity, type of delivery and mother-infant attachment. The results of this research show that maternal attachment style is one of the factors of mother -infant attachment.

Delayed onset of lactogenesis II is one of the reasons of poor lactation outcomes. Recently,obesity in mother is implicated in delayed onset of lactogenesis II. Therefore, this study was performed to assess the relationship between the onset of lactogenesis II and antropometric indices at 14±1 days following child birth. This descriptive and analytic research was conducted in Shahid Rajaee hospital of Tonekabon City and Imam Sajjad hospital of Ramsar City. The samples were 103 parturient women who were enrolled by purposive sampling. According to mother's report of latogenesis II,they were put into two groups,with lactogenesis II within 72 hours and beyond,respectively. Then anthropometric indices of mothers were registered on 14th day after delivery.Data gathering was done by interview, observation forms and file. Analysis of data was performed by student t-test, Chi square, Mann-Whitney, Fischer's exact test, Pearson correlation, and Multivariate-Logistic regression. Pearson coefficient test showed a direct meaningful relationship between anthropometric measurements at 14 days following child birth onset of lactogenesis II. There were relationship between onset of lactogenesis II and mid arm circumference (r=0.248, P= 0.012), skin fold thickness (r=0.233, P=0.018), Calf circumference (r=0.387, P< 0.001), body mass index (r=0.378, P<0.001). By using logistic regression, results of study revealed the role of BMI is more significant in delayed onset of lactogenesis II (P= 0.006), and R.O.C curve defined that mothers with BMI ≥ 29 are at risk for late onset of lactogenesis II (P< 0.001). All of the antropometric indices have direct and meaningful relation with onset of lactogenesis II, but Body Mass Index has more significant role in comparison to other factors.

Vaginitis is the most prevalent gynecological complaint for which women seek medical treatment. Amongst different methods of diagnosis of bacterial vaginosis Amsel`s clinical criteria and Nugent scoring is of the most preferentiality. The aim of this study is to evaluate the diagnostic values of whole Amsel`s clinical criteria, each of Amsel`s criterion solitarily and combination of two criteria, respectively, for diagnosis of bacterial vaginosis. This study is carried out on 105 women referring to gynecologic clinic of 17-Shahrivar Hospital (Mashhad, Iran, 2006-2007) who underwent speculum examination and were qualified to enroll in study. The Nugent scoring system was used as the gold standard method for diagnosis of bacterial vaginosis. Sensitivity, specificity, positive predictive value and negative predictive value of whole Amsel`s clinical criteria, each of Amsel`s criterion solitarily and combination of two criteria for the diagnosis of bacterial vaginosis were determined according to the aimed standard. Among Amsel’s clinical criteria, the most sensitive individual criterion was clue cells (96.9%) and the criterion with the highest specificity was Whiff test (80.8%). PH plus clue cells and clue cells plus vaginal discharge were the most sensitive coupled combinations (84.4%), whereas the combination of clue cells and Whiff test was of the highest specificity (89%). The clinical criteria for the diagnosis of bacterial vaginosis can be simplified into two clinical criteria with no considerable decline in their sensitivity and specificity.

Background and Mother–infant attachment has gained momentum in mental health in recent years. Also partner violence against pregnant women is an important health problem all over the world. The present study was designed to determine the relationship between domestic violence intensity in pregnancy and mother-infant attachment. Methods and Materials: In this deh1ive analytical study 102 pregnant women admitted to healthcare centers in Mashad in 2008 were included through stratified clustered sampling. Information on domestic violence during pregnancy was collected through "Conflict Tactics Scale" and "Mother to Infant Attachment Inventory" 4-5 weeks after delivery. Obtained data were analyzed in SPSS using Spearman correlation coefficient Kruskal Wallis Mann Whitney U and multiple regression. In general 89.2% of women experienced very mild 9.8% experienced mild and 1% moderate levels of domestic experience from their partners. Negative significant relationships were found to exist between verbal (p=0.032 r= - 0/21) and physical violence (p=0.005 r= - 0.27) injuries (p=0.018 r= - 0.23) total score of violence (p=0.002 r= - 0.29) and mother-infant attachment. Also mean scores of psychological (p=0.026 ms=15/9±12/94) and physical (p=0.002 ms=9/1±11/12) violence injuries (p=0.006 ms= 2/5±3/47) and total score of violence (p=0.038 ms= 47/6±33/68) were significantly higher in the group of partners dissatisfied from the pregnancy of their wives. However no significant differences were found between educational levels of men and women and different types of violence. The results indicate the correlation of verbal and physical violence as well as injuries during pregnancy with mother–infant attachment.

Preeclampsia is a common complication of pregnancy often leading to significant maternal and fetal complication. Preeclampsia occurs more frequently in primigravidaes and multigravidaes who are a change in paternity. This study is performed to assess relationship unprotected coitus with preeclampsia.Method and material: In this analytic(case-control)study 91 primigravidae in case group and 91 primigravidae in control group in age range for 20-35 years were chosen form mothers selected by purposeful sampling.Data gathered by interviews Examination form developed by the investigator. Analysis of data was performed by independent T-Test, Mann-whitney, Chi-square, Logestic-Regression by utilizing spss software and 95% coefficient. Women with a short period of co-habitation or who used barrier methods for contraception had a substantially elevated risk for development of preeclampsia compared with women with more than 4 months of cohabitation before conception.(p=0.0001)Oral contraceptive users had a lower preeclampsia rate than of woman who used no oral contraceptive. (p=0.003) No relationship was observed between coital rate before and during pregnancy and risk for preeclampsia.Discussion and comment: This study suggests a relationship between sperm exposure and risk for preeclampsia, and that the risk of developing preeclampsia in primigravidae is inversely proportional to the length of sexual co-habitation.