معصومه غضنفرپور

One of the missions of medical universities is educational planning to solve the problems of society. Considering the increase in Iran’s aged population, this study aims to assess the need to revise the “counseling in midwifery” curriculum in medical universities for improving the plan of “support for families and the youth of the population” in Iran.

This is a qualitative study using the content analysis method. The information was obtained using semi-structured interviews with five professors and five graduates of Counseling in Midwifery from Kerman University of Medical Sciences, regarding the need for updating the counseling in midwifery curriculum.

Based on the content analysis, the following six main themes (recommendations) were extracted: “supporting the family and the youth of the population”, “maintaining and improving the fertility rate of women and men”, “ training of experts to prevent infertility”, “childbearing and sexual health consulting”, “improving mothers’ health status and children’s growth and development” and “increasing marriage rate and reducing divorce rate”.

It is necessary to revise the “Counseling in Midwifery” curriculum to implement the plan of “support for families and the Youth of population” in Iran. The presented recommendations should be applied in this academic discipline by medical universities of Iran.

Polycystic ovary syndrome is one of the most common endocrine disorders, whose symptoms usually begin immediately after the first menstrual period. Previous studies found a significant relationship between dysmenorrhea, premenstrual syndrome and polycystic ovary syndrome. The aim of this study is to investigate the effect of chamomile on dysmenorrhea and premenstrual syndrome in patients with polycystic ovary syndrome.

This clinical trial was conducted on 70 patients diagnosed with polycystic ovary syndrome based on Rotterdam criteria referring to a clinic in Mashhad. Patients were randomly assigned to two groups. The first group received two 500 mg chamomile capsules per day and the second group received two placebo capsules per day for three months. The response to treatment in premenstrual syndrome, dysmenorrhea and oligomenorrhea was evaluated using the Visual Analogue Scale and DSM-IV premenstrual syndrome diagnosis questionnaire.

The mean age of the patients in the intervention group was 25.43±5.58 and in the placebo group was 28.06±5.71 years. The rate of improvement in women with premenstrual syndrome (16.6%), dysmenorrhea (50%) and oligomenorrhea (26.7%) was higher in chamomile group compared to placebo. There was no statistically significant difference in body mass index between the chamomile group (25.17±4.95) and the control group (25.57±6.7).

Based on the results of this study, chamomile improved the symptoms of oligomenorrhea in patients with polycystic ovary syndrome and showed positive effects on dysmenorrhea and premenstrual syndrome. Therefore, chamomile can be used as a simple, low-cost therapy in the treatment of polycystic ovary syndrome patients.

Considering the priority of supporting vulnerable groups when fighting against COVID-19, the present study aimed to evaluate the levels of COVID-19-induced anxiety and depression in two vulnerable groups: medical staff and pregnant women. The present study is a descriptive cross-sectional study performed on 140 treatment staff and 338 pregnant women. The questionnaire used in this study includes demographic characteristics and the Hospital Anxiety and Depression Scale- modified. Univariate and multiple linear regression analysis and analysis of variance were used to identify the effect of variables on anxiety and depression. Among the staff, 88.6% were women. The mean and standard deviation of their COVID-19-induced anxiety and depression were 12.76 ± 1.78 and 7.75 ± 2.27, respectively. The staff exhibited high levels of abnormal anxiety, with 92.9% reporting symptoms. In contrast, the prevalence of abnormal depression among the staff was lower, with only 11.4% reporting symptoms. Marital status (p=0.05) and exercise (p=0.03) significantly affected the covid-19-induced depression of the medical staff. The mean and standard deviation of COVID-19-induced anxiety and depression in pregnant women were 10.53 ± 2.04 and 11.15 ± 2.09, respectively, and these scores were significantly different compared to the medical staff groups. Vulnerable groups had high levels of anxiety and depression associated with COVID-19. Nurses prioritized psychological programs targeting anxiety reduction, while pregnant women prioritized psychological programs addressing depression reduction.

Considering the issue in the population of postmenopausal women, no study has been conducted in Iran so far on the relationship between body fat distribution and quality of life. This study aimed to investigate the correlation between body fat distribution and quality of life in menopausal women.

The present descriptive study was conducted on 250 premenopausal and menopausal women aged 40-65 years. Samples were selected by a multi-stage random sampling method. Data were collected through a two-part questionnaire including demographic variables and a questionnaire on the postmenopausal women’s life quality in health centers. The data were analyzed using Statistical tests, distribution, frequency percentage mean score, Standard deviation, and independent sample t-tests.

The mean age of participants was 55.17 years. There was a statistically significant difference between the two forms of body fat distribution in the vasomotor domain (p = 0.021), the physical domain (p = 0.044), and the sexual domain (p = 0.001), but no statistically significant difference was observed for the psychological domain (p = 0.148).

The results of the present study showed a significant difference in some aspects of the postmenopausal women’s life quality with pear-shaped and gynoid fat distribution.

Counseling services in Iran are required to understand the motivations for childbearing to provide better services. This study was conducted to investigate the confirmatory factor analysis of the Childbearing Questionnaire (CBQ) in Iranian men and women.

In this cross-sectional study, 398 married women of reproductive age (15-49 years of age) and 390 men, whose wives were at similar age were recruited. They were selected from Mashhad healthcare settings using multi-stage cluster sampling. The participants completed the CBQ. The reliability of the CBQ was assessed by test-retest and Cronbach's alpha. The validity of the scale was evaluated applying confirmatory factor analysis. SPSS V19 and Amos-21 were used for data analyses.

Cronbach's alpha coefficient and the test-retest reliability indicated satisfactory reliability of the CBQ in terms of positive childbearing motivation and negative childbearing motivation. The original model did not show acceptable fit. After removing eight factors with low loading and two correlated error terms, the modified model was found to have adequate fitness.

This study showed that some of the positive and negative motivations have changed due to cultural values of the Iranian society and are different compared with those of the western societies. This study supported the use of CBQ as a valid instrument in assessing childbearing motivations in Iran.

The factors which lead to a reduction in pain and length of labor with minimal intervention have always been of interest to researchers. The present study was performed aimed to compare the effect of TENS with psychological supportive intervention on labor pain and maternal and neonatal outcomes in pregnant women referring to the maternity ward.

This clinical trial study was performed in 2021 on 90 pregnant women admitted to the delivery block of Payambar Azam hospital of Kerman. The subjects were randomly divided into three groups of TENS (n=30), psychological supportive intervention (n=30) and control (n=30). In the active labor phase, TENS was applied for the TENS group, the psychological supportive intervention was performed in the counseling group, and routine care was performed for the control group. Scores of pain during the active phase of labor (4 cm and 10 cm dilatation) and maternal and neonatal outcomes were compared in the three groups. Data were analyzed by SPSS statistical software (version 21) and Fisher's exact and variance analysis tests. P< 0.05 was considered statistically significant.

There was no significant difference between the three groups in the scores of labor pain in 4 cm dilatation, maternal complications, Apgar scores 1 and 5 minutes, and type of delivery (p> 0.05). However, the score of pain in 10 cm dilatation in the TENS group and counseling group similarly was significantly reduced compared to the control group. The duration of the first stage of active phase labor was not significantly different between the three groups (p> 0.05), but the difference between the duration of the second stage of the active phase and the total duration of the active phase was significant between the three groups (p >0.05).

Both methods of psychological supportive counseling and transcutaneous electrical nerve stimulation (TENS) are equally effective in reducing labor pain and length of labor; considering the safety of both methods, it is recommended to use these two methods to facilitate the birth process.

In most parts of the world, pelvic girdle and lower back pain are one of the most common musculoskeletal disorders, but its prevalence has been reported differently in studies around the world. were performed to investigate the-analysis Therefore, the present meta prevalence of pelvic girdle and lower back pain in pregnant women.

all articles published from 2005 to May 2020 using the keywords Pelvic Girdle Pain, Low back pain, Cross-Sectional, Prevalence, Epidemiology, Survey in Scopus, PubMed, Web of Science Core Collection,Science Direct and SID collected and reviewed. Munn et al. tools were used to evaluate the quality of studies and methodology.

26 studies with a sample size of 13430 showed that, the overall prevalence of pelvic girdle and low back pain in pregnant women is 50% (95% CI: 43-58%, I2: 98.9%) and in primigravida women 44% (95% CI: 35-54%, I2: 97.9). Also, the prevalence of pelvic girdle and low back pain was using the questionnaire 57% (95% CI: 47-68, I2: 99.04%), using a combination of methods 53% (95% confidence interval: 37-70, I2: 96.12%), using a VAS Scale 38%(95% confidence interval: 23-52, I2: 99.08%).

The results of the present study indicate a 50% prevalence of pelvic girdle and low back pain in pregnant women. Due to the high prevalence and effects of pain on the quality of life of pregnant women, it seems necessary to plan, policy and design effective interventions in this field by the treatment team.

Polycystic ovary syndrome is the most common endocrine disorder in women of reproductive age. Therefore, in this study, the prevalence of hirsutism, overweight and menstrual disorders, which have a high comorbidity with this syndrome, and its relationship with age, marriage, and the use of related medications were investigated among students in the dormitory of Kerman University of Medical Sciences.

This cross-sectional study was conducted among students in the dormitory of Kerman University of Medical Sciences in 2019-2020. The prevalence of hirsutism, menstrual disorders, polycystic ovary syndrome (based on NIH criteria) and overweight were calculated. The polycystic ovary syndrome screening questionnaire was used for screening and its relationship with age, marriage and the use of related medications was measured.

636 students with an average age of 21.99±3.61 participated in this study. 13.9% of students had a menstrual cycle of more than 35 days. 70.6% had a menstrual cycle of 25 to 34 days. In terms of the growth of thick dark hair, 17.1% experienced hair growth in more than two areas of the body, and most reports of hair growth were related to chin, chest, and abdomen with 31.4%, 29.9%, and 23.2%, respectively, and 45.3% of subjects did not report hirsutism. Moreover, 30.8% were overweight and 4.7% had galactorrhea. With a confidence interval of 95%, the prevalence of polycystic ovary syndrome was 10.6 (3.2-18.0). Age and the use of medications had a significant relationship with these symptoms.

The results of this study showed that the prevalence of polycystic ovary syndrome among students is not higher than the average of the society, and it occurs more in people over 22 years of age and people who take medications.

 In Modern technology, using mobile phones is the most exposed to waves in the world. As far, public concern has been rising regarding exposure to phone waves, especially in critical periods such as intrauterine life and early childhood. This study aimed to conduct a systematic review of literature have investigated the relationship between exposure to radiofrequency waves during pregnancy and early childhood with physical and behavioral problems in children.

 We searched databases (PubMed, Web of Science, ISI, Cochrane Library, and Scopus), along with Persian databases such as SID and Magiran with the keywords: "Prenatal Period", "Pregnancy", "Mobile phone", "Children", "Radiofrequencyexposure", "Cell phone'', ''electromagnetic field'', and ''Behavioral problems'' from 1st. January 2010 until 1st. March 2020. After applying the inclusion and exclusion criteria, out of 55 articles, 15 were selected.  

 The results of some studies have not demonstrated the occurrence of behavioral problems in children who were exposed to radiofrequency waves during pregnancy until 36 months. But between the ages of 7 and 11, emotional-behavioral problems were reported. In contrast to other studies, one study showed a positive effect of reducing sentence complexity and improving motor skills in three-year-old children of mothers exposed to cell phone waves. Although, the Findings of dose-response (low, medium, and high exposure) were Controversial. In this review, meta-analysis studies found a significant relationship between the effects of exposure and the incidence of leukemia in children. Also, The incidence of migraine and children's exposure to magnetic fields showed a significant association. However, there was a weak association in the case of hearing loss problems. 

 Although, the results indicated a significant relationship between physical and behavioral problems in children due to exposure to the waves. However, We emphasize the importance and necessity of further research to investigate the biological effect of waves during pregnancy, and childhood to recognize the factors affecting children's diseases.

Despite the studies have been published as review or systematic, the effect of ormeloxifene on mastalgia has not been well elucidated. Therefore, this study was performed with aim to determine the effect of ormeloxifene on mastalgia in clinical trial studies.

To perform this review study, the English electronic databases including ISI Web of Science, PubMed, Scopus, and Cochrane Library; also, Magiran and Scientific Information Database (SID) were searched without time limitation until January 1, 2021, by using the keywords of Mastalgia or Mastalgias or Mastodynia, or Mastodynias or Mammalgia or Mammalgias, and Breast Pain, Breast, pain, and Centchroman or Selective Estrogen Receptor Modulators (SERM), and Systematic Review, and Meta-Analysis.  

Twelve studies were included in this systematic review, and the results of nine studies were combined in the meta-analysis. The percentage difference before and after treatment with ormeloxifene was significant (p<0.001), and ormeloxifene resulted in 86% improvement in breast pain relief (87%; CI:0.83-0.90). The result of the Q test showed moderate and insignificant heterogeneity between the studies (P=0.14; I2=33%). Also, the findings of the two studies have indicated significant efficacy of ormeloxifene.

The results of the meta-analysis supported the efficacy of ormeloxifene in relieving breast pain. However, the analysis of the findings in this meta-analysis should be interpreted with caution due to the high heterogeneity between the studies, small sample size, and the limited number of studies.

Labor pain and anxiety have negative effects on mother, fetus, and consequently the labor process. Qurchr('39')an is treated with great respect by Muslims and there are interests toward non-medical interventions based on religious beliefs during labor. This review article examined the effect of listening to Qurchr('39')an recitation on severity of pain and anxiety during labor.

We conducted a systematic review and meta-analysis in PubMed, Scopus, Web of Science, Google scholar, and Persian databases until March 2020 using the following keywords: labor pain, anxiety, Qurchr('39')an, Holy book, and clinical trial. Jadad scale was used to evaluate the quality of the articles.

There were four studies on the effect of listening to Qurchr('39')an recitation on intensity of pain during labor and two studies on its effect on anxiety during labor. There were significant differences in standardized mean difference of labor pain intensity between the intervention and control groups (-0.616, 95% CI: -387- -0.845, P< 0.001) indicating that listening to a recitation of Qurchr('39')an can significantly reduce the severity of labor pain. Two other studies showed that listening to Qurchr('39')an recitation reduces anxiety level in first stage of labor (P<0.001).

The present study showed that listening to Qurchr('39')an recitation could decrease the intensity of pain and anxiety during labor. Therefore, health care providers should consider the beliefs of expectant mothers and use spiritual examples such as listening to Qurchr('39')an recitation to achieve successful childbirth.

Many women suffer from mastalgia; this issue is very important due to the importance of proper use of the drug. Due to the complications of chemical drugs, patients tend to use complementary medicine. Therefore, this systematic review was conducted with aim to compare the effects of evening primrose oil and vitamin E on cyclic mastalgia.

In this systematic review and meta-analysis, data related to comparison of evening primrose oil and vitamin E were searched using the key words of mastalgia, evening primrose oil, vitamin E, and breast pain in the Electronic databases of Pubmed, Scopus, Web of science, Magiran, Iran doc, Iran medex, SID, and also Google scholar without time limitation until 2019. Jedad Index was used to evaluate the quality of the studies. Data were analyzed by Comprehensive Meta-analysis Version 2.

Among 701 articles found in the initial search, 8 randomized trials with sample volume of 878 participants were selected for this systematic review. The studies were conducted in U.S, India, Pakistan and Iran. The result of meta-analysis showed that the difference between two groups of intervention and control was .311 (95% CI: -0/266 to 0/888) and the difference was not statistically significant (p=0.291); this indicates that the efficacy of Evening promise oil and vitamin E is similar.

The efficacy of Evening promise oil and vitamin E in treatment of mastalgia is similar. Given the high heterogeneity of studies, low sample size and the variety of methods for determining the outcome, further studies in this field is recommended.

Dysmenorrhea is a common complain among young females students that impairs their educational performance, and their quality of life. Considering the importance of drinking enough water for health, the present study was conducted to assess the modifying role of water intake on quality of life of university students suffering from primary dysmenorrhea.

This Quasi-experimental research was conducted on 70 university students suffering from primary dysmenorrhea and had less than 1600 ml water intake per day. They were asked to modify their water intake based on a proposed protocol for two menstrual periods. Health related quality of life was examined by the 36-item short-form health survey questionnaire (SF-36) before and after intervention.  Using Wilcoxon signed-rank test quality of life was compared before and after modifying water intake.

Among physical and mental health summary measures of the SF-36, an inverse significant difference was observed between physical functioning, bodily pain, general health, role-emotional and mental health between and after intervention.

There was a significant difference between quality of life of university students who changed their water intake and suffered from primary dysmenorrhea indicating the modifying role of drinking water as a non-pharmacological intervention for primary dysmenorrhea.

Mastalgia is one of the most common causes of women referring to treatment centers that regarding its importance, proper administration of the drug is important. Due to the complications of chemical drugs, the patients' tendency to use complementary medicine has been increased. This systematic review and meta-analysis was conducted with aim to evaluate and summarize the results of clinical trials on the effects of herbal medicines and dietary supplements on mastalgia in Iran. This systematic review and meta-analysis evaluated the effect of herbal medicines and supplements on Mastalgia by searching the articles using the keywords of mastalgia, complementary medicine, herbal medicine, their English in Persian and English journals indexed in SID, Iranmedx,  Irandoc, Magiran, Scopus,  Pubmed  and Google scholar from 2007 until 2019. The Jadad scale was used to evaluate the quality of the articles. The inclusion criteria were: the randomized controlled trials (RCTs) on mastalgia and exclusion criteria were: no access to the full text and the existence of more than one intervention in each group and lack of control group. In this study, 14 articles with inclusion criteria were evaluated which had antioxidant, flavonoid, anti-inflammatory and analgesic properties and had a good effect on mastalgia relief. The obtained data supports the use of Vitagnus and vitamin E for the treatment of mastalgia. In addition, cotton seed also provided good results. The results of the meta-analysis on three studies showed no significant difference between vitamin E and Evening Primrose (p = 0.648). Among all the above mentioned methods, Vitagnus and Vitamin E have more evidence for use in the treatment of mastalgia. Further studies are needed to apply other methods.

One of the most common problems in postmenopausal women is sleep disorders. This disorder can be manifested by mild to severe symptoms of discomfort in different people. One of the approaches to relieve sleep disorders is the use of complementary medicine, including aromatherapy. This systematic review and meta-analysis was conducted with the aim to evaluate and summarize the results of clinical trials on the effects of aromatherapy in premenopausal and postmenopausal women with sleep disorders.

Latin databases such as PubMed, Scopus, ISI Web of Science, Cochrane Library, and Persian databases such as SID and magiran were systematically searched until 10 February 2018 without time limitation. The Jadad scale was used to evaluate the quality of the articles. Sleep duration or sleep quality was considered as the main outcome of the study.

Among 4 found studies, Lavender essence was used for aromatherapy alone or in combination with other methods or fragrances. The results of the meta-analysis on three studies which had reported the quality of sleep showed that the standardized mean difference between intervention and control groups was 1.338 (95% CI: 0.329-2.347); this difference shows sleep quality score was improved in the intervention group compared to the control group (p = 0.009). In one study which had reported the sleep time of samples, there was no significant difference between intervention and control groups in sleep hours (p = 0.373).

Lavender essence aromatherapy alone or in combination with other methods can have beneficial effects on improving the sleep quality in pre and postmenopausal women

Hot flashes are the most common symptoms experienced by women around the time of menopause. Many women are interested in herbal medicines because of fear of side effects of hormone therapy.

The aim of this systematic review was to assess the effectiveness of Iranian herbal medicines in alleviating hot flashes.

MEDLINE (1966 to January 2015), Scopus (1996 to January 2015), and Cochrane Central Register of Controlled Trials (The Cochrane Library, issue 1, 2015) were searched along with, SID, Iran Medex, Magiran, Medlib and Irandoc. Nineteen randomized controlled trials met the inclusion criteria.

Overall, studies showed that Anise (Pimpinella anisum), licorice (Glycyrrhizaglabra), Soy, Black cohosh, Red clover, Evening primrose, Flaxseed, Salvia officinalis, Passiflora¡ itex Agnus Castus, Piascledine (Avacado plus soybean oil), St. John''s wort (Hypericum perforatum), and valerian can alleviate the side effects of hot flashes.

This research demonstrated the efficacy of herbal medicines in alleviating hot flashes, which are embraced both with people and health providers of Iran Therefore, herbal medicine can be seen as an alternative treatment for women experiencing hot flashes.