فهرست مطالب مهری جمیلیان

Pumpkin plant has medicinal properties in the treatment of various metabolic disorders, which despite its good effectiveness, there is still no consensus on its use during pregnancy. Therefore, the purpose of the present study was to determine and investigate the effect of using pumpkin on the treatment of non-alcoholic fatty liver disease and the occurrence of gestational diabetes in pregnant women.

In the present study conducted as a randomized clinical trial in 2016, 60 pregnant women with non-alcoholic fatty liver disease were selected and randomly assigned to the group receiving the diet with pumpkin in the amount of 100 grams for 6 weeks and the group Diet recipients were divided alone. Serum metabolic indices, fatty liver grade, B-Mode ultrasound and gestational diabetes were compared between the two groups. Collected data were analyzed using Kolmogorov-Smirnov statistical tests, analysis of variance, chi-square, t-test, Wilcoxon, McNemar and chi-square.

The results of the present study indicated that the metabolic indices of ALT, AST, ALP, LDL, and Chol had a significant difference between the intervention and control groups after the intervention (p<0.05). The comparison of fatty liver grade after the intervention did not show a statistically significant difference between the two groups (p>0.05). The amount of changes in B-Mode ultrasound after treatment was significant in both intervention (p=0.001) and control (p=0.046) groups. The point of the findings should be written in more detail, it is very dumb and incomprehensible

Based on the obtained results, it was concluded that the use of pumpkin in pregnant mothers did not have a dissimilar effect than the placebo in the treatment of non-alcoholic fatty liver and on the incidence of gestational diabetes, so its use is not recommended for this purpose.

We are aware of no study that examined the effects of vitamin E plus omega-3 fatty acid supplementation on inflammatory and oxidative stress biomarkers in pregnant women with gestational diabetes (GDM). This study aimed to evaluate the effects of vitamin E plus omega-3 supplementation on insulin metabolism and inflammatory and oxidative stress biomarkers in pregnant women with gestational diabetes. This randomized, double-blind, placebo-controlled clinical trial was performed on 60 women with GDM. Subjects were randomly assigned to receive either 400 IU vitamin E plus 1000 mg omega-3 fatty acid supplements (n=30) or placebo (n=30) for 6 weeks. Fasting blood samples were taken at study baseline and after 6 weeks of intervention to quantify biochemical variables.
Findings: Vitamin E plus omega-3 fatty acid supplementation led to a significant rise in plasma total antioxidant capacity (+187.5±224.9 vs. -32.5±136.1 mmol/L, p<0.001) and a significant decrease in MDA levels (-0.1±0.9 vs. +0.6±1.4 µmol/L, p=0.04) compared with placebo. Furthermore, a significant increase in plasma NO levels (+5.0±7.7 vs. -12.0±28.0 µmol/L, p=0.002) was seen after vitamin E plus omega-3 fatty acid supplementation compared with the placebo. Vitamin E plus omega-3 fatty acid supplementation in GDM women had beneficial effects on biomarkers of inflammation and oxidative stress

Polycystic ovary syndrome (PCOS) is a common endocrine disorder associated with metabolic complications, which affects about 5-10% of women of reproductive age. The present study was designed with the objective of investigating the effect of selenium supplementation on lipid profile and indices of glucose and insulin metabolism in women with PCOS.
This randomized double-blind controlled clinical trial, was conducted on 70 women with PCOS (age range, 18-40years)s. The participants were randomly divided into two groups (each 35 subjects), including the group that received selenium supplementation (200µg, daily) and the group that received placebo (100mg cellulose, daily) for 8 weeks. Fasting blood samples were collected at baseline and after 8 weeks. Data was analyzed using the analysis of covariance (ANCOVA) statistical test.
Selenium supplementation significantly decreased the serum insulin level (-29.83±47.29vs .07±77.12pmol/l, p=0.013), homeostasis model of assessment-insulin resistance (HOMA-IR) (-1.15±1.81vs .42±3.09, p=0.011), homeostatic model assessment beta cell function (HOMA-B) (-19.06±30.95vs .55±47.99, p=0.017), and increased the quantitative insulin sensitivity check index (QUICKI) (.03±0.04 vs .0009±0.05, p=0.032) compared to the placebo group. In addition, serum triglyceride level (-0.14±0.55vs .11±0.30mmol/l, p=0.025) and very-low-density lipoprotein (VLDL) concentration (-0.03±0.11 vs .02±0.06 mmol/L, p=0.025) significantly decreased after the intervention.
The findings of this study revealed that daily intake of selenium supplement in women with PCOS may have beneficial effects on insulin metabolism indices, serum triglyceride level, and VLDL level

Selenium supplement has multiple important effects, including anti-inflammatory effect. The aim of this study was to assess the effects of selenium supplement on gene expression of inflammatory cytokines and vascular endothelial growth factor in gestational diabetes.
This randomized double blind placebo control trial was performed on 40 patients suffering from GDM aged 18–40 years old. Participants were randomly divided into interventional group receiving 200mg/day selenium supplements (n=20) and control group receiving placebo (n=20) for 6 weeks. Primary outcome was gene expression of inflammatory cytokines and VEGF which were assessed in lymphocyte of GDM patients by RT-PCR method.
After 6 weeks intervention, in comparison with the control group, interventional group showed down regulation of gene expression of tumor necrosis factor alpha (TNF–α) (p=0.02) and transforming growth factor beta (TGF–β) (p=0.01) and up-regulation of gene expression of vascular endothelial (VEGF) (p = 0.03) in lymphocytes of GDM. There was not any significant change following intervention with selenium regarding gene expression of interleukin IL-1 β and IL-8 in lymphocytes of GDM patients.
6 weeks supplementation with selenium in patients with GDM can cause down regulated gene expression of TNF-α and TGF–β, and up regulated gene expression of VEGF. Selenium supplement had not any effect on gene expression of IL-1 β and IL-8.

Hypothyroidism and hyperthyroidism have been known as the most important reasons for DUB (dysfunctional uterine bleeding) that presents as menstrual irregularities. Regarding to the effects of thyroid hormones on mense, levothyroxine intake may be effective on DUB in euthyroid women.
Material and In this interventional randomized, double-blind, placebo-controlled clinical trial on 120 women aged 35-55 years old with DUB that they had no organic reasons and had normal thyroid function and they were taking oral contraceptive pill (OCP), were divided in two groups that each group included 60 women. The intervention group took one tablet of levothyroxine 0.1 mg daily and control group took placebo for three months and after 3 months, comparison between two groups were performed by using SPSS software 16 and in order to data analyzing paired t test and student t test and covariance analysis was used.
Our study showed the overall recovery rate of all kinds of mense irregularities was 48(80%) and 51(85%) in intervention and control groups respectively that shows there was no difference in comparison to pretreatment (P=0/47). The comparison of recovery rate based on different kinds of mense irregularities in two groups showed that recovery rate in metrorrhagia was significantly more in intervention group (100%) than control group. Based on covariance analysis, a meaningful recovery rate in duration and interval bleeding, and the number of used pads was seen in intervention group in comparison to control group (F=4.352, P=0.006).

We are aware of no study examining the effects of Soy supplementation on patients with polycystic ovary syndrome (PCOS).This study was conducted to evaluate the effects of Soy supplementation on metabolic profiles in women with PCOS.
This randomized, double-blind, placebo-controlled clinical trial was conducted among 70 women diagnosed with PCOS. Participants were randomly divided into two groups to receive 50 mg Soy isoflavone supplements (n=35) or placebo (n=35) for 12 weeks. Fasting blood samples were taken at baseline and after a 12-week intervention to quantify related factors.
Intervention group, subjects who received Soy supplements had significantly decreased total serum testosterone levels (-0.2±0.4 vs. .1±0.3 ng/mL, p=0.01) compared with the placebo. In addition, a significant rise in plasma glutathione (.0±102.2 vs. .7±157.8 µmol/L, p=0.04) and a significant decrease in malondialdhyde levels (-0.7±0.8 vs. .8±2.3, p=0.001) was observed following the consumption of Soy supplements compared with the placebo.
According to this study, Soy supplementation among PCOS women had beneficial effects on metabolic profiles.

The efficacy of evening primrose oil has been reported in metabolic syndrome and other diseases.The role of vitamin D has been proposed in the risk reducing of chronic diseases such as obesity, metabolic syndrome and diabetes too. We are aware of no study that examined the effects of evening primrose oil and vitamin D supplementation on metabolic profiles in gestational diabetes (GDM). This study was designed to assess the effects of evening primrose oil and vitamin D supplementation on metabolic profiles among pregnant women with GDM.
This randomized, double-blind, placebo-controlled clinical trial was performed among 60 women with GDM. Subjects were randomly assigned to receive either evening primrose oil and vitamin D supplements (n=30) or placebo (n=30) for 6 weeks. Fasting blood samples were taken at study baseline and after 6 weeks of intervention to quantify biochemical variables.
Evening primrose oil and vitamin D supplementation led to a significant decrease in serum high sensitivity-C reactive protein (hs-CRP ) levels (change from baseline: -1.9±4.0 vs. .6±2.6 µg/mL, p=0.006) and MDA (-0.8±2.1 vs. .6±1.5 µmol/L,p=0.005) compared with placebo. Furthermore, a significant increase in plasma NO (.5±3.8 vs. -1.9±8.1 µmol/L, p=0.009) and TAC levels (.4±174.8 vs. -36.4±143.1 mmol/L, p=0.005) was seen after evening primrose oil and vitamin D supplementation compared with placebo.
Evening primrose oil and vitamin D supplementation in GDM women had beneficial effects on metabolic profiles.

We are aware of no study evaluating the effects of zinc supplementation on metabolic profiles of patients with polycystic ovary syndrome (PCOS). This study was conducted to evaluate the effects of zinc supplementation on glucose homeostasis parameters in PCOS women.
This randomized, double-blind, placebo-controlled trial was conducted among 52 women diagnosed with PCOS and aged 18-40 years old. Participants were randomly divided into two groups to receive 220 mg zinc sulfate (containing 50 mg zinc) supplements (n=26) or placebo (n=26) per day for 8 weeks. Fasting blood samples were taken at baseline and after 8 weeks of intervention to quantify glucose and insulin.
After 8 weeks of intervention, zinc-supplemented patients had reduced fasting plasma glucose (FPG) (-4.3±9.6 vs. .5±6.0 mg/dL, p=0.03), serum insulin (-3.0 ± 2.9 vs . 1.5 ± 8.4 µIU/ml, p=0.01), serum triglycerides levels (-15.6±40.3 vs. .5±25.3 mg/dL, p=0.002) and a significant increase in insulin sensitivity (.02±0.02 vs. -0.004±0.05, p=0.03) compared with the placebo.
Taken together, 220 mg zinc sulfate supplementation per day for 8 weeks among PCOS women had beneficial effects on metabolic profiles.

Few studies have examined the effects of calcium plus vitamin D supplementation on metabolic profiles in overweight women with polycystic ovary syndrome (PCOS).This study was conducted to determine the effects of calcium plus vitamin D supplementation on metabolic profiles among overweight women with PCOS.
This randomized double-blind placebo-controlled clinical trial was conducted among 104 overweight and obess women with PCOS. Participants were randomly assigned into four groups to receive: 1) 1000 mg/d calcium vitamin D placebo; 2) 50000 IU/weeks vitamin D; 3) 1000 mg calcium/d and 4) calcium placebo vitamin D placebo for 8 weeks. Fasting blood samples were taken at baseline and after 8 weeks intervention to measure metabolic profiles.
After administrating calcium plus vitamin D supplementation, a significant decrease was observed in serum insulin (-3.3±11.4 vs.-1.1±8.5, -1.4±3.0 and .1±6.1 µIU/ml, p=0.03), insulin resistance (-0.7±2.4 vs.-0.3±2.5, -0.2±0.6 and .8±1.9, p=0.04), malondialdehyde (-0.6±0.3 vs.-0.1±0.2, -0.5±0.2 and .6±0.4 µmol/L, p=0.009) and a significant rise was seen in total antioxidant capacity (.2±21.7 vs..5±37.7, .1±34.1 and -153.8±65.2 mmol/L, p=0.006) and glutathione (�.0±79.3 vs.-47.5±60.2, .9±31.3 and -160.8±82.9 µmol/L, p=0.001) compared with vitamin D, calcium and placebo groups.
In conclusion, calcium plus vitamin D supplementation for eight weeks among women with PCOS had beneficial effects on metabolic profiles.

The relationship that develops between the midwife and women is at the core of human care. However, there is a lack of knowledge about the communication features of midwifes and mothers in various situations and settings. Thus, their experience in the delivery room can be the basis for the body of knowledge in their profession and provide a clear and comperhensive concept of their relationship based on the prevailing sociocultural context.
The present qualitative content analysis was conducted on 32 participants who were selected through purposive sampling. The participants consisted of 16 midwifes and 16 mothers hospitalized in the postpartum ward of a hospital affiliated to Arak University of Medical Sciences in 2013. Data were gathered through unstructured and semi-structured interviews. Interviews were transcribed verbatim and analyzed using the conventional content analysis approach. Sampling ceased when data saturation was achieved.
The data analysis revealed 2 themes that encompassed the midwife-mother relationship. The 2 themes were communication as the essence of midwifery care and reflection of communication. Each theme consisted of clasifications and main codes.
According to the results, the concept of the midwife-mother relationship in the delivery room was identified as therapeutic alliance. The findings enhanced understanding of the meaning and dimensions of the midwife-mother relationship beyond the traditional meaning. This study offers evidence of the essence of this relationship and may go some way towards the creation of a written body of midwifery knowledge. The results can assist midwives in providing holistic and high quality care to mothers during labour, and thus, provide positive outcomes in normal child birth.

There is lack of knowledge about features of midwife-mother relationship in different condition and setting where the midwife has different levels of responsibility in terms of the normal and high-risk pregnancy. This study aimed to develop a scale for evaluating the midwife- mother relationship in delivery room.
Methods & Materials: This is a methodological research. Participants were 480 mothers who hospitalized at post-partum ward in a university hospital of Arak, Iran in 2014. Preliminary item pool was developed by qualitative part of the study and literature review. Target group determined the validity of the instrument by using the impact item method. The validity of the questionnaire was determined with content validity ratio (CVR), content validity index (CVI), face validity and exploratory factor analysis. Reliability of the instrument was reported by Alpha Cronbach coefficient.
In the qualitative phase 66-item of questionnaire was developed. Those with impact item index over 1.5, CVR over 0.42, and CVI over 0.79 were considered as valid; while the rest were eliminated resulting in a 48-item scale. Exploratory factor analysis loaded a 43-item with a four factor solution that jointly accounted for 60.4% of observed variance. Cronbach’s alpha coefficient showed excellent internal consistency (α=0.95).
The findings showed that the designed questionnaire was a valid and reliable instrument for measuring midwife- mother relationship in delivery room. It is easy to use the scale, and it contains the most significant features of midwife-mother relationship.

Adoption has a significant role for strengthening families without children and also resolution of psychological confilicts of unsupervised children. The goal of this study is to assess the psychological status of adoption applicant couples.
This is a descriptive- analytic study that is done with cooperation of welfare organization and Arak University of Medical Sciences in 2014. All adoption applicant couples referred to welfare organization for 1 year participated in the study. Data were gathered by using demographic questionnaire and MMPI-II. Data were showed by descriptive statistic and were analyzed by using mean, average and covariance analysis indices.
Mean and standard deviation of all clinical scales and reliability of MMPI-II in all samples and also different subgroups of statistical population were under 65. All applicants had good mental health and psychologically were eligible for adoption. A group of applicants have pretended themselves better than what they are because of the fear of rejection that led to significant difference in k scale(p=0.019).
According to the findings of this study, applicants had good mental health and didn’t have any psychopathologic damage, but sometimes they have pretended themselves better than what they are. Investigation of other diagnostic tools in future studies is recommended.

Missed abortion refers to pregnancy products remain dead with age less than 20 weeks in the womb for several weeks. This study was designed to evaluate the efficacy of castor oil on cervical ripening in the treatment of abortion. This triple blind clinical trial was done on 72 women with missed abortion who were divided into two groups of 36 patients based on odd or even numberd of cases. The case groups received 800 mg vaginal misoprostol and 60 ml castor oil mixed with fruit juice and control groups received 800 mg vaginal misoprostol and 60 ml placebo with fruit juice, respectively. In both groups, if needed, 3 doses of vaginal suppository 800 mg were repeated with at least 24 hours. After the disposal of pregnancy products, sonography and curettage were performed if necessary. During the intervening period, the time of the opening of the cervix in the intervention group was shorter than control group and there was a statistically significant difference (p=0.032). Also, the control group required a higher frequency of administration of misoprostol than intervention group and the difference was statistically significant (p = 0.037). It seems that the castor oil can be effective on cervical ripening for treatment of abortion.

Nausea and vomiting are among the most common complications of Caesarean section and may cause suture dehiscence, esophageal perforation, gastric aspiration, and delay in hospital discharge. The aim of this study was to compare the antiemetic effect of Ginger, Gabapentin, and Ondansetron for prevention of nausea and vomiting after cesarean section by spinal anesthesia. This randomized, double-blind placebo controlled clinical trial was done on 208 women undergoing elective cesarean section. After taking written informed consents, they were divided into four equal groups. 300 mg Gabapentin, 8 mg Ondansetron, 1 gr Ginger, and placebo were administered to each group. Before performing spinal anesthesia and after the operation in recovery, and also in 2, 4, and 6 hours intervals after the surgery, nausea and vomiting were recorded based on a four point scale. Data was analyzed by SPSS 19 using one way ANOVA, independent t-test and Chi square. There were no significant differences among the four groups according to age, gravidity; mothers` mean atrial pressure and heart rate before and during surgery, newborns` APGAR score and mothers` consciousness. Nausea and vomiting in Gabapentin (0.28±0.34), Ondansetron (0.28±0.25), and Ginger (0.27±0.85) groups were significantly less than placebo group (1±0.22) (p=0.01), whereas there were no significant differences among the three groups (p=0.05). Using Gabapentin, Ondansetron and Ginger with the same antiemetic effect are appropriate for women undergoing cesarean section.

Episiotomy is one of the most common gynecologic surgery that was done in the second stage of labor, in order to facilitate the delivery. Cutting this area is associated with pain and discomfort. Healing causes pain relief and returning to daily activities became faster. Considering that the high rates of episiotomy infection, we decided to examine the effect of topical cream, saffron 20%, on women who had undergone episiotomy. This randomized, double-blind clinical trial study was performed on 60 primiparous women in 2013-2014 who underwent vaginal delivery and episiotomy at in Taleghani Hospital of Arak. Intervention group recieved 20% topical cream containing saffron extract three times daily for 2 weeks and the control group received a placebo cream. Wound status and its healing were investigated in the first, seventh and fourteenth postpartum. There was a significant difference between both groups with healing of episiotomy location in seventh(p=0.54) and fourteenth(p=0.003) days and the continuity process of the wound edges in the first (p=0.015), seventh(p=0.013) and fourteenth(p=0.001) days. there was no statistically significant difference about the opening the wound in the first day(p=0.492), There was a statistically significant difference between the two groups in seventh(p=0.001) and fourteenth(p=0.026) days. This study showed that saffron extract cream 20% can be effective for episiotomy wound healing and wound edges continuity.

About 40% of postmenopausal women experience sleep disruption which can affect their quality of life. Various medications were used for managing the sleep disruption. There are some studies on the effectiveness of gabapentin in the management of post menopausal vasomotor symptoms and sleep disruption. The aim of present study was to assess the effect of gabapentin on improving quality of life and sleep of post menopausal women. In this double blind clinical trial, 90 post menopausal women with sleep disruption were selected and randomly divided into two groups for 12 weeks; intervention (300 mg gabapentin, twice daily) and control groups. SF36 questionnaire of quality of life and PSQI questionnaire of sleep quality were surveyed and compared before and after the intervention in patients. The mean age of participants were 52.7 ± 3.14 and 53.4±3.68 years in intervention and placebo groups respectively. There was no significant difference in demographic information and the mean score of SF36 and PSQI questionnaires between groups before the intervention (p>0.05). Significant improvement was seen in score of SF36 and PSQI in gabapentin group after the intervention and in comparison with placebo group (p=0.0001). According to the results of present study, it seems that gabapentin 300mg/twice daily for 12 weeks can improve quality of life and sleep of post menopausal women.

Polycystic ovary syndrome (PCOS) is a complex hormonal disorder affecting the reproductive and metabolic systems. The aim of this study was to investigate the effect of 8- week pilates training on anti-mullerian hormone level and cardiometabolic parameters in women with polycystic ovary syndrome. In this semi-experimental study with pretest – posttest design, twenty PCOS patients (aged 28.16±4.29 y) were randomly assigned to pilates training or non-exercising control groups. The training group took part in an eight-week progressive pilates exercise program, three times weekly while the control group were instructed to maintain their normal daily activities throughout the eight-week experimental period. Serum levels of anti-mullerian hormone, body composition and metabolic parameters were assessed before and after the training period. After an 8 week pilates training, insulin resistance index, total cholesterol, LDL- cholesterol, triglycerides and abdominal fat were significantly decreased (p<0.05). Furthermore, anti-mullerian hormone concentrations decreased significantly in response to pilates training (p<0.05). These results suggest that pilates training can have beneficial effects on metabolic indices and ovarian reserve in women with polycystic ovary syndrome over a two-month period.

The incidence of ectopic pregnancy varies between 1.5-2% of all pregnancies. Bilateral tubal ectopic pregnancy is rare. It may occur in 1 per 200 000 pregnancies.Case: This is a case report of 25 year-old woman who underwent intra uterine insemination (IUI), because of tubal factor infertility (unilateral). On the 30PthP day after the IUI she complained from pelvic pain and vaginal bleeding. Pelvic ultrasound showed bilateral tubal ectopic pregnancy with fluid in Douglas Pouch and empty uterine cavity. Exploratory laparotomy, left salpingectomy, and right salpingostomy were performed on the same day of admission. The above case suggests that cases presenting with infertility and ectopic pregnancy should be followed very closely with β-hCG and or Trans Vaginal Sonography (TVS) to exclude double ectopic. So, as in this case, early diagnosis is essential for prevention of maternal morbidity and mortality

Premenstrual syndrome (PMS) refers to a cyclic appearance of somatic and psychiatric symptoms that affect some women. Finding an effective and safe method for the treatment of PMS has always been a serious concern. The purpose of the present study is to evaluate the effect of omega-3 fatty acids and rose damascena in the treatment of PMS. A randomized placebo controlled clinical trial was performed on 120 women. The women randomly assigned into 3 equal groups. The first group received omega-3 500 mg/day، the second group received rosa damascene 30 drops/day and third group was as control group that received placebo during leuteal phase for 3 consecutive cycles. The severity of each of the symptoms were compared in all groups before and after intervention. Statistical analysis was performed using chi-square tests، fischer exact test، and ANOVA. There were no significant differences among the groups according to age، BMI، level of education، and the severity of primary symptoms. The mean severity of affective and psychological symptoms including tension، depression fatigueability، decreased libido، lack of concentration، crying، suicidal thonghts increased appetite in rosa damascene group were significantly lower than the other groups (p=0. 001)، and the mean severity of physical symptoms including edematous extrimities، breast tenderness، bloating and palpitation in omega-3 group were significantly lower than the other groups (p=0. 001). Headache and forgetfullness have not any meaningfull difference between groups. Rosa damascena and Omega-3 seems to be effective in reducing psychiatric and somatic symptoms of PMS. Therapeutic use of these drugs needs further studies.

Depression is one of the common psychiatric disorders which are more common in women in the reproductive ages. So this study is to investigate the effect of Depo-Provera on depression. This cross-sectional study was performed on 70 women who had chosen Depo-Provera as contraception. Beck test was done at arrival and repeated 3 months later، and the scores obtained were compared by paired t test. The participants BDI scores at baseline were equal to 7. 89±3. 85 while 3 months after treatment with the scores were equal to 7. 09±3. 63 which were significantly decreased. Since Depo-Provera reduces depressive symptoms in women who take it and does not increase these symptoms in women with a history of depression، it seems that Depo-Provera is an appropriate choice as contraception.

Today، ultrasonography has become the main tool used for the evaluation of fetal anomalies. The aim of this study was to evaluate fetal heart rate changes immediately after combined two- and 4-dimensional ultrasound. This study was performed on 191 pregnant women aged 15 to 45 years old who were referred for 4-dimensional ultrasonography in summer 2013. Before the onset of 2-dimensional ultrasonography، baseline fetal heart rate was measured by ultrasound. At the same time، the maternal heart rate was recorded during one minute. Then، combined ultrasonography was performed and same parameters were recorded at the end. Maternal heart rate significantly decreased after combined ultrasonography (P=0. 0001). Fetal heart rate did not differ before and after ultrasonography (P=0. 693). Four-dimensional ultrasonography has no effect on fetal heart as an indicator for evaluating the fetus temperature.

Increasing the duration of admission and labor has harmful effects on mother and fetus. Lack of maternal education and preparedness increase medical intervention and create complications for both mother and baby. Therefore،Childbirth preparation classes during pregnancy can be an appropriate solution to address these problems. This was a HSR and descriptive – analytical sort of research، which was performed during 2009-2011 in Arak Taleghani Hoapital. 170 nulliparous pregnant women who were selected by simple sampling، were assigned in to two group (case and control). Case group participated in preparation classes for eight sessions، 2 hours once two weeks، and trained with a coach of midwifery. Control group received only usual pregnancy care. The duration of admission and satisfaction of mothers were assessed and gathered by questionnaire. Data were analyzed by SPSS software. Duration of admission in the case group (30. 70±11. 14hours) was significantly shorter than the control group (38. 17±15. 33hours. p=0. 001). Satisfaction rate of mothers in the case group (94. 20%) was significantly higher than the control group (67. 24%. p=0. 001). Our study showed Childbirth preparation classes decrease duration of admission and increase satisfaction of mothers. Therefore it is recommended that all pregnant women participate in these classes during

Primary dysmenorrheal is one of the most common gynecologic diseases. This study was carried out to compare the effects of omega-3 and vitamin E on the treatment of primary dysmenorrheal. In a randomized double-blind clinical trial, 80 female students from high schools in Arak, Iran, were selected by simple sampling and randomly divided into two identical groups in 2010. Omega-3 group received one omega-3 capsule (500 mg) per day while the vitamin E group received one vitamin E capsule (400IU) every other day for 60 days. Intensity of pain, duration of pain, and the number of painkillers taken before and after intervention were measured in both groups. Intensity of pain was assessed by VAS scale of pain. Data were analyzed by SPSS software. After intervention, the mean of pain intensity in the omega-3 group decreased to 3.5 which indicated a significant difference in comparison with the corresponding values before intervention (7.40) (p<0.05) and the values in the vitamin E group (5.25) (p<0.05). After intervention, the mean duration of pain in the omega-3 group reached 11.04 hours which showed a significant difference compared with the corresponding values before intervention (31.74) (p<0.05) and the values in the vitamin E group (34.81) (p<0.05). Omega-3 is more effective than vitamin E in the treatment of primary dysmenorrheal and its application as a new therapeutic method to the treatment of primary dysmenorrheal requires further studies

Noticing the significant role of fertility in Iranian families, the incidence of infertility and its social and cultural dimensions, this study was carried out to compare general health status of infertile women with fertile women. This observational case-control study was done on 147 women as the control group and 147 infertile patients as the case group who were matched in terms of influential variables. Data collection was done through demographic questionnaire and general health questionnaire (GHQ) which were completed by both groups. The results were analyzed by logistic regression analysis, t test, and chi-square using STATA 10 software. Means of general health score in fertile and infertile women were 19.249.72 and 28.06 10, respectively. Here the mean score of the infertile women was significantly higher in comparison with the fertile women (p<0.001). Physical symptoms, anxiety, social interaction, and depression scores of infertile women were significantly higher in comparison with the fertile women (p<0.001). There were no significant differences in the means of age and duration of marriage between the two groups and the distribution of educational level, occupation, and income levels were the same in the two groups. Average scores of general health and physical complaints, anxiety, impaired social interaction, and depression in infertile women were higher than those in fertile women. This indicates their involvement with some degrees of public health diseases.