فهرست مطالب roghayyeh ahangari

Third- and fourth-degree perineal tears are considered severe, whose prevalence rate is different based on the population, place, and time, and several factors can be involved in their occurrence.

This study aims to determine the prevalence of severe perineal tears during normal vaginal delivery (NVD) and its risk factors among women in Qom, Iran.

This is a descriptive-analytical retrospective study with a case-control design, which was conducted on the medical records of women who gave birth from March 2010 to March 2019 in three teaching hospitals in Qom (n=115,107). Those with third- and fourth-degree perineal tears were put in the case group (n=138), and those with no severe perineal tears were considered as controls (n=138). Information was collected using a checklist surveying demographic information, previous medical history, and obstetric information. The data analysis was done using independent t-test, chi-square test, Fisher’s exact test, and multivariate logistic regression analysis. The significance level was set at 0.05.

Among 115,107 childbirths in the hospitals, 138 cases (0.12%) had third- and fourth-degree tears. The mean age of women was 27.00±4.64 years and their mean gestational age was 39.09±1.05 weeks. None of the mothers consumed alcohol, and only two were smokers. The birth weight of newborns, parity, length of the first and second stages of labor, nationality, and time of delivery were significantly different between the two groups (P<0.05). The results of the multivariate logistic regression analysis showed that only the variables of birth weight of newborn (OR=0.91, 95% CI; 0.96%-0.99%, P=0.009), length of the first stage of labor (OR=0.06, 95% CI; 0.02%-0.19%, P=0.001) and length of the second stage of labor (OR=0.04, 95% CI; 0.03%-1.1%, P=0.001) were the significant predictors of severe perineal tears.

the high birth weight of newborns and the prolongation of the first and second stages of labor are the risk factors for severe perineal tears. Therefore, it is recommended that obstetricians in Iran pay attention to these risk factors in the management of the labor process.

Milk and dairy products are important sources of food-borne pathogens. Non-pasteurized dairy products are popular due to home production, beliefs about their higher nutritional value, high accessibility, and taste.

This study aims to investigate the consumption pattern of local dairy products in women in Qom, Iran, in 2022, and determine the affecting factors.

In this cross-sectional study conducted in 2022, 319 women in Qom were selected using a stratified random sampling method. Their demographic information (age, educational level, employment status, and income) and consumption of local dairy products were surveyed. In addition, a questionnaire based on the theory of planned behavior (TPB) with 32 items and 4 subscales (attitude towards nutrition, subjective norms, behavioral intention, and nutritional behavior) was completed. The data was analyzed in SPSS software using ANOVA, and Chi-square test.

Overall, the consumption rate of local milk was 82.3 %; yogurt, 85.1 %; cheese, 57.3%; cream, 53.7 %; butter, 42.3 %; and curd, 33.9 %. Regarding the daily consumption rate, the highest consumption rate was related to milk (13.9 %) and yogurt (11.8 %), and the lowest consumption was related to curd (3.1%) and cream (5.1 %). The type of dairy consumed was significantly related to behavioral intention and nutritional attitude (P<0.05). There was a significant difference in the type of consumed dairy in terms of the husband's occupation (P=0.001), but there was no significant difference in terms of educational level, marital status, employment status, and relationship with the villagers (P>0.05).

The prevalence of local dairy products consumption, especially milk and yogurt, is high in women living in Qom. Their behavioral intention to consume healthy dairy products is at good level, but they do not have proper nutritional attitude and nutritional behavior. Therefore, the risk of developing common zoonotic diseases, including brucellosis and crimean-Congo hemorrhagic fever is high in Qom.

Lecture is the most common teaching method used in ethics education, while problem-based learning (PBL) and small group discussion (SGD) have been introduced as more useful methods. This study compared these methods in teaching medical ethics. Twenty students (12 female and 8 male) were randomly assigned into two groups. The PBL method was used in one group, and the other group was taught using the SGD method. Twenty-five open-ended questions were used for assessment and at the end of the course, a course evaluation sheet was used to obtain the students'' views about the advantages and disadvantages of each teaching method, their level of satisfaction with the course, their interest in attending the sessions, and their opinions regarding the effect of teaching ethics on students'' behaviors.The mean score in the PBL group (16.04 ± 1.84) was higher than the SGD group (15.48 ± 2.01). The satisfaction rates in the two groups were 3.00 ± 0.47 and 2.78 ± 0.83 respectively. These differences were not statistically significant.Since the mean score and satisfaction rate in the PBL group were higher than the SGD group, the PBL method is recommended for ethics education whenever possible.