Objective: Polycystic ovarian syndrome (PCOS) is a common condition amongst women of reproductive age that can result in increased mortality and morbidity in women due to increased risk of diabetes mellitus and cardiovascular diseases. The aim of this systematic review was to assess the effectiveness of common treatments of PCOS on the predictors of diabetes in non-diabetic PCOS women.
Materials and methods: An extensive search was performed on the publications in three medical databases including pubmed, scopus and google scholar from 1995 till 2017. The articles were screened based on their quality and included in this systematic review. A total of 25 articles including cohort, randomised controlled trial, review and meta-analysis were included in the review.
Results: This systematic review revealed that the effect of lifestyle modification might be low in PCOS subjects due to high drop-out rate while the benefits of this intervention including weight and fat reduction may not be achieved by medical interventions. Metformin treatment may result in improvements in insulin sensitivity while its weight reduction effect is still not documented in PCOS subjects. Thiazolidendiones might be tolerated by the PCOS subjects and may result in similar effects as metformin but this effect should be documented by further studies.
Conclusion: Combination of lifestyle modification with metformin or thiazolidinedions might improve the outcome of the prevention strategies. On the other hand this study revealed a different response to treatments in non-obese compared with obese PCOS subjects.

Objective: Social support and perceived self-efficacy affect health-related behaviors and play an important role on mothers' adaptability with pregnancy. This paper aims to study the impact of educational interventions based on social support and perceived self-efficacy on maternal prenatal care.
Materials and methods: The present study is a before after experimental study in which 90 first-time pregnant women were randomly selected and divided into two 45- participants experimental and control groups. Data were collected from 21 January to 20 May 2016. Determining the validity and reliability of the questionnaire, we used the panel of experts and Cronbach's alpha. The data collected from the two groups were compared before and 3 months after intervention and were analyzed by SPSS 18.
Results: Unlike the control subjects, there was a significant difference in maternal prenatal cares before and after an educational intervention between the scores of social support and perceived self-efficacy in the experimental group (p < 0.05). Before intervention, the average score of the experimental group was 12.62 ± 2.63 that rose to 17.71 ± 1.56, three months after the educational intervention, which is statistically significant (p < 0.05). There was a direct and positive relation between self-efficacy and maternal prenatal cares (p = 0.000, r = 0.538). Social support and self-efficacy predicted the variance of maternal cares by 69.2%.
Conclusion: Developing an educational program based on social support and perceived self-efficacy on maternal prenatal cares is helpful and efficient. The health system, family and society are in charge of making facilities and opportunities to improve social support and perceived self-efficacy in pregnant women, resulting in improved maternal prenatal cares.

Objective: This study aimed to determine the relationship between vitamin E in the follicular fluid (FF) and serum with oocyte morphology and embryo quality.
Materials and methods: A cross-sectional study was conducted on serum samples, FF samples, oocytes, and embryos collected from 50 women undergoing in vitro fertilization in the Alzahra Hospital, Rasht, Iran from March to August 2014. Vitamin E level was measured using HPLC. Oocyte morphology and embryo quality were evaluated during inverted optical microscopy.
Results: Totally 434 oocytes and 199 embryos were examined. Most frequently the metaphase II (MII) oocytes were observed at the 0.35-1 mg/dl level of vitamin E in FF (89.2%) and the 1-5 mg/dl level of vitamin E in serum (86.1%). The odds of having MII oocytes at the level of 0.35-1 mg/dl (OR = 2.48, 95% CI = 1.24-4.94) and 1.5-2 mg/dl (OR = 2.51, 95% CI = 1.02-6.19) of vitamin E in FF was significantly higher compared to level of 2-7.4 mg/dl. The effect of vitamin E serum level on oocyte maturation was not significant. The odds of having embryo with Z1 or Z2 quality, at the 10-15 mg/dl level of vitamin E in serum (OR = 6.45, 95% CI = 1.18-35.22), compared to the 15-20 mg/dl level, was significantly higher. The effect of vitamin E levels in FF on the embryo quality was not significant.
Conclusion: At certain levels of vitamin E in the FF, oocytes with higher maturation and at certain levels of vitamin E in serum, embryo with higher quality can be achieved.

Objective: To evaluate the effects of acupuncture branches on postpartum low back pain severity among the primiparous subjects visiting the selected educational centers affiliated to Shiraz University of Medical Sciences, Shiraz, Iran.
Materials and methods: This clinical trial was conducted on 150 (each group of 50 people) cases in 2012. Cupping therapy was done every other day in four 15-20 minute sessions a week. Besides, acupressure was applied according to the circular model for 20 minutes. The patients filled out the short form McGill Pain Questionnaires. Then, the data were analyzed using the SPSS statistical software
(v. 16) and repeated measurements and Chi-square tests.
Results: In the cupping group, the mean difference of postpartum Low Back Pain intensity reached from 31.8 ± 10.8 before the intervention to 9.0 ± 6.7, 7.5 ± 6.6, and 4.1 ± 3.6 immediately, 24 hours, and
2 weeks after the intervention, respectively and the results of repeated measures ANOVA showed a significant difference between the three follow-up periods (p < 0.05). On the other hand, this measure reached from 31.1 ± 11.0 before the intervention to 22.1 ± 7.3, 16.2±6.0, and 11.7 ± 5.3 immediately, 24 hours, and 2 weeks after the intervention, respectively in the acupressure group.
Conclusion: The study results showed that these modalities could sedate the pain. Therefore, they can be applied as efficient treatments for reducing the low back pain.

Objective: To determine the effect of Air Quality Index (AQI) in the first trimester of pregnancy on birth weight, placental weight, and the ratio of placental weight to the birth weight (pw-bw) in Isfahan.
Materials and methods: This cross-sectional study was done on 312 consecutive pregnant women in Beheshti Hospital in Isfahan city in 2013. Information on air pollution was received from the Environmental department of Isfahan. Average exposure to air pollution in the first trimester of pregnancy was calculated for eachpregnant woman. In order to compare quantitative and qualitative variables, analysis of variance (ANOVA), and chi-square were applied. After that, the multiple linear regression analysis was used to assess the association the Air Quality Index (AQI) on birth weight, placental weight and the ratio of pw-bw. Potential confounders including age, baby gender, smoking of husband, maternal BMI, maternal occupation, and education and mother’s residential area were considered. A statistical significant association were considered for P-value less than 0.05.
Results: The findings showed that there is inverse relationship between exposure to air pollution and placental weight in the first trimester of pregnancy after controlling potential confounders (β = -2.57, p-value = 0.008). The inverse relationship between air pollution and the ratio of pw-bw was found. (β = -0.001, p-value = 0.002).
Conclusion: The results of this study suggest that air pollution is associated with newborns’ health which in turn is a warning alarm for considering some actions in both sides of reducing the air pollution and teaching the pregnant women about the adverse effects of air pollution on the pregnancy outcomes.

Objective: To evaluate association of blood and seminal plasma lead and cadmium with sperm quality of non-occupationally exposed male partners of couples with infertility.
Materials and methods: A cross-sectional study was conducted on 75 men aged 20-45 years (mean = 37.1 ± 7.0 yrs.) with infertility recruited from the Fertility Clinic of a hospital in Abakaliki. Sperm count done in accordance with the WHO guidelines was used to classify the participants as normospamia, oligospermia and azospermia. Atomic absorption spectrophotometer was used to determine lead and cadmium levels in plasma from blood and semen.
Results: There were 15 azospermics, 22 oligospermics and 36 normospermics. Seminal and blood plasma cadmium as well as blood plasma lead were significantly (p < 0.01) higher in azospermic and oligospermic men compared to normospermic men. However, while seminal plasma lead was significantly (p < 0.05) higher in oligospermic and normospernic men than in azospermic men, the seminal plasma lead was comparable between oligospermic and normospermic men. Significant inverse associations (p < 0.01) were found between blood and seminal cadmium levels and sperm count, motility and morphology; blood lead was inversely correlated with sperm count only.
Conclusion: The study suggests that environmental exposure to cadmium and lead may contribute to development of poor sperm quality and infertility in men of reproductive age in Nigeria.

Objective: To determine the effect of vaginal hygiene module to attitudes and behavior of pathological vaginal discharge prevention in adolescent girls in Sleman Regency, Yogyakarta, Indonesia.
Materials and methods: This present study is a quasi experiment with pretest and post-test control group design. A total of 80 female students was selected randomly from two secondary schools at the study site and then distributed equally to control and experimental group. Only participants in the experimental group were given self-learning vaginal hygiene module to maintain vaginal cleanliness. A questionnaire was used as an instrument to measure the attitudes and behavior of vaginal discharge prevention. Paired and independent sample t-tests with significance level (p value) at 0.05 and Confidence Interval (CI) of 95%were employed to compare the mean difference.
Results: There is a significant difference in the students’ attitude and practice of pathological vaginal discharge prevention between intervention and control group. The students who have been exposed to vaginal hygiene module for six months showed better attitudes and practice in pathological vaginal discharge prevention compared to their counterpart in control group who do not receive any module.
Conclusion: The present study implied that vaginal hygiene module can be provided widely for female adolescents at their early puberty. District health officers may work closely with schools’ health promoter to reach the students and create a supportive environment for reproductive health discussion and forum in order to achieve better adolescents’ reproductive health status.

Objective: To assess reproductive health service utilization and associated factors among adolescents in Anchar District, West Hararghe Zone, Oromia Region, East Ethiopia.
Materials and methods: A community based cross-sectional study using quantitative and qualitative method of data collection was applied from March 1to 30, 2013. Simple random sampling method was used for quantitative and Purposive sampling technique used for qualitative method. Four hundred two adolescents were interviewed for quantitative study. Four focus groups and ten in-depth interviews were conducted for qualitative study. Binary and Multiple logistic regressions were used for association at
p < 0.05 using SPSS Version 16.0 software. Qualitative data was transcribed, and result was presented by narration.
Results: Forty two (39.3%) female adolescents have ever used family planning. One hundred eight four (45.8%) adolescents have ever used VCT services. Males were 5.25 times more likely to use VCT than females (AOR = 5.25,C.I = 1.07, 25.87) and those perceived themselves as high risk for HIV were 8.22 times more likely to use VCT than their counterparts (AOR = 8.22, C.I = 1.065, 35.49). Lack of adolescent reproductive health services, Harmful Traditional Practices, lack of privacy and inconvenient service hour were reasons for not utilizing the service.
Conclusion: More than half of adolescents were not utilizing family planning, and VCT services. Therefore, intensified effort is needed to increase utilization of these services for adolescents.