Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 8 3 2014 09 15 91 5 Saghar Samimi Sede Department of anesthesiology, women Hospital, Tehran University of medical sciences, Tehran, Iran. Fateme Davari Tanha Department of obstetrics & gynecology, women Hospital, Tehran University of medical sciences, Tehran, Iran. Mehrnaz Valadan Department of obstetrics & gynecology, women Hospital, Tehran University of medical sciences, Tehran, Iran. Zeinab Modaressi Department of anesthesiology, women Hospital, Tehran University of medical sciences, Tehran, Iran. 2015 10 16 Objective: To detect whether the preoperative combined administration of rectal diclofenac and paracetamol is superior to placebo or rectal diclofenac alone for pain after abdominal hysterectomy. Materials and methods: Ninety female patients (American Society of Anesthesiologists (ASA) physical status I-II), scheduled for abdominal hysterectomy were recruited to this double blind trial and were randomized to receive one of three modalities before surgery: rectal combination of diclofenac and paracetamol, rectal diclofenac alone or rectal placebo alone which were given as a suppository one hour prior to surgery. The primary outcomes were visual analogue pain scores measured at 0, 0.5, 2, 4, 8, 16 and 24 hours after surgery and the time of first administration and also total amount of morphine used in the first 24 hour after surgery. A 10 cm visual analog scale (VAS ) was used to assess pain intensity at rest. Results: In patients receiving the combination of diclofenac and paracetamol total dose of morphine used in the first 24 hour after surgery was significantly lower (13.9 ± 2.7 mg) compared to diclofenac group (16.8± 2.8 mg) and placebo group (20.1 ± 3.6 mg) (p < 0.05). VAS pain score was significantly lower in combination group compared to other groups all time during first 24 hours (p < 0.05). There had been a significant difference between combination group and the two other groups in terms of the first request of morphine (p < 0.05). Conclusion: According to our study Patients who receive the rectal diclofenac-paracetamol combination experience significantly a lower pain scale in the first 24 hour after surgery compared with patients receiving diclofenac or placebo alone. Their need to supplementary analgesic is significantly later and lower compared to placebo and diclofenac alone. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/214 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/214/209

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 8 3 2014 09 15 97 100 Maryam Moghani Lankarani Medicine and Health Promotion Institute, Tehran, Iran. Nasrin Changizi Ministry of Health and Medical Education, Tehran, Iran. Mohammadreza Rasouli Medicine and Health Promotion Institute, Tehran, Iran. Mohammad Amir AmirKhani Ministry of Health and Medical Education, Tehran, Iran. Shervin Assari Department of Health Behavior and Health Education School of Public Health University of Michigan, MI, US. 2015 10 16 Objective:To determine the impact of a national intervention program on some pregnancy complications in Iran. Materials and methods: this multicenter study was conducted in governmental sector in 14 provinces in Iran between 2003 and 2005. Intervention included education of all maternal health care providers including gynecologists, general physicians, and midwifes in the governmental sector. Time interval between the pre- (of 3,978 and 3,958 pregnancies) and post- (3,958 pregnancies) measurements were 18 months. Self reported data on pregnancy complications were registered. Interviews were conducted by trained personnel. Participants were interviewed when admitted for delivery or at the time attending for vaccination of their 2 month infants. Results:The following pregnancy complications were reduced significantly as compared to before intervention: 1) bleeding or spotting, 2) urinary tract complications, 3) blurred vision and severe headache, 4) premature labor pain, 5) anemia, 6) severe vomiting, 7) inappropriate weight gain, 8) endometritis, 9) urinary incontinence, 10) breast abscess or mastitis, 11) wound infection, and 12) bleeding was significantly reduced after intervention, compared to before intervention. Premature rupture of membrane showed a significant increase. These complications did not show a significant change: 1) hypertension, 2) fever and chills, 3) convulsion, shock, and loss of consciousness, and 4) obstetric fistula. Conclusion:National programs may be proved to be largely effective by decreasing some of the pregnancy complications in developing countries. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/212 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/212/207

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 8 3 2014 09 15 101 5 Meisam Akhlaghdoust Young Researchers' Club and Elite, Tehran Medical Branch, Islamic Azad University, Tehran, Iran. Nesa Zarbati Sarem Cell Research Center- SCRC, Sarem Women's Hospital, Tehran, Iran. Zhila Amirkhani Islamic Azad University Research Center, Medical Tehran Branch, Tehran, Iran. Sara Naimi Students' Research Committee, Tehran Medical Branch, Islamic Azad University, Tehran, Iran. Mohamadreza Sadeghi Young Researchers' Club and Elite, Tehran Medical Branch, Islamic Azad University, Tehran, Iran. Sahar Mohammadi Fateh Sarem Cell Research Center- SCRC, Sarem Women's Hospital, Tehran, Iran. Mina Jafarabadi Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 16 Objective:In view of the effect of hard labor on pregnancy outcomes and to determine risk factors, in this study, the effect of spacing between pregnancies was evaluated for probable effect on the incidence of dystocia in labor. Materials and methods:This is a cross - sectional study used the records of 210 pregnant women referred to Azad University hospitals between January 2000 and December 2012. Dystocia was diagnosed according to ICD-9-CM. Data were analyzed using statistical software Spss17. Results:It was found that in pregnancies with 2-4 years spacing between births normal delivery was more prevalent while in the group with 8-10 years spacing labor dystocia was more prevalent. Conclusion:Based on the findings of this study the interval between pregnancies has a significant effect on labor dystocia. Increasing the spacing between pregnancies more than 8 years is a risk factor for dystocia. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/210 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/210/205

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 8 3 2014 09 15 107 12 Fatemeh Nahidi Tarbiat Modares University, Tehran Iran. Sedigheh Sadat Tavafian Tarbiat Modares University, Tehran Iran. Mohammad Haidarzade Department of paediatrics, Tabriz Medical Sciences University, Tabriz, Iran. Ebrahim Hajizadeh Department of Biostatistics, Medical Sciences Faculty, Tarbiat Modares University, Tehran, Iran. 2015 10 16 Objective:Despite the benefits of mother-newborn skin-to-skin contact (SSC) immediately after birth, the process has not been universally implemented as routine care for healthy term neonates. The purpose of this study was to determine opinions of the midwives about enabling factors of SSC immediately after birth in Tehran hospitals in 2012- 2013. Materials and methods:This study has been conducted in a descriptive method based on PRCEDE-PROCEED model. The samples were 292 midwives from 18 hospitals. We used stratified and then simple random sampling. In this study midwives were working at delivery room; deliveries were conducted by midwives or they were in charge of the newborn immediately after birth. Data collection instrument was a self developed questionnaire concerning the enabling factors in the SSC. We applied face and content validity ratio (CVR), content validity index (CVI) and item impact method for the instrument's validity and Cronbach's Alpha for reliability. Finally, data were analyzed and interpreted using spss-18 through descriptive statistics. Results:The results show that 90.4% of the midwives believed in necessity of a plan, 96.2% believed that good services should be provided to mothers, and 97.9%, 85.3% and 93.8% of them believed there is a need for private space, essential facilities and essential equipment for skin contact process; with Cronbach's Alpha of 0.731, 0.551, 0.501, and 0.600 respectively. Conclusion:Most of the midwives believed that enabling factors concerning the successful SSC are effective. We suggest further studies on other enabling factors effective in SSC from the view point of midwives, gynaecologists and caregivers. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/208 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/208/203

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 8 3 2014 09 15 113 6 Leila Amini Department of Midwifery, School of Nursing & Midwifery, Iran University of Medical Sciences, Tehran, Iran. Kobra Valian Department of Midwifery, School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran. Homa Sdeghi Avvalshahr Midwifery Department, School of Nursing & Midwifery, Iran University of Medical Sciences, Tehran, Iran. Ali Montaeri Mental Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran. 2015 10 16 Objective: To compare self-confidence in woman with and without PCOS according to their ages. Materials and methods: This comparative study was conducted on 400 women (100 with and 300 without PCOS) in clinics of Shahid Akbar-Abadi and Firouzgar Hospitals, from July 2012 to February 2013. SPSS-16 used for statistical analysis (SPSS; SPSS Inc., Chicago, IL, USA). Results: This study showed 98% of PCOS and 93% in non-PCOS groups had average self-confidence with scores of 15-25. None of women in PCOS group and 6.7% of non-PCOS group had high self-confidence (score > 25). There was a significant difference between two groups in term of self-confidence level (p < 0.001). There was no significant difference in self-confidence between age group ≤ 30 and age group > 30 in both group, but in PCOS group, self-confidence were significantly higher in both age group under 30 (p < 0.0001) and 30 and higher (p < 0.0001). Conclusion:Impaired self-confidence in PCOS groups (under 30 and 30 and higher age groups) in comparison with related value of non-PCOS group shows that mental health status in women with PCOS requires urgent psychological attention and support. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/206 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/206/201

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 8 3 2014 09 15 117 22 Monoarul Haque Department of Community Nutrition, Bangladesh University of Health Sciences (BIHS), Dhaka, Bangladesh. Farah Kamal Department of Community Medicine, Noakhali Medical College, Noakhali, Bangladesh. Shahanaz Chowdhury Department of Community Medicine, Bangladesh University of Health Science, Dhaka, Bangladesh. Monir Uzzaman Department of Community Medicine, Bangladesh University of Health Science, Dhaka, Bangladesh. Itrat Aziz Department of Gynecology and Obstetrics, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. 2015 10 16 Objective:To identify the non-obstetric causes and presentation of acute abdomen among pregnant women. Materials and methods:This was a cross sectional hospital-based study among 128 pregnant women by face to face interview using a semi-structured questionnaire. This study was conducted at the Gynecology & Obstetric Ward of 250 Bed General Hospital, Noakhali, Bangladesh, from January to August 2013. Data were analyzed by a software package used for statistical analysis (SPSS) version 11.5 (SPSS, Inc., Chicago, IL, USA).Mean age of participants was 25±4 years. Our findings showed that 81% were Muslim, 67% were lower middle income group, as well as 47% completed primary level of education. The results revealed that 28% had biliary ascariasis, 24% had peptic ulcer disease and 10% had lower urinary tract infection. We also found that 6% had acute pyelonephritis, 6% had acute gastroenteritis, 6% had acute cholecystitis, 6% had acute appendicitis, 2% had acute pancreatitis, 3% had choledocolithiasis, 2% had ovarian solid mass, 2% had twisted ovarian cyst, 4% had renal colic, and 1% had renal calculus. In non-obstetrical presentation of acute abdomen, the study found that 84% of respondents complained their pain lasting more than 24 hours. Besides, half of respondents felt pain in epigastrium and right hypochondrium. Cramping, prickling and aching type of pain were more, while 66% suffered from continuous pain. Our results also showed that 73% did not explain any aggravating factor and relieving factor, and the rest said food, fasting state and position change aggravated pain as well as relieved pain. Conclusion:The study concludes that precise diagnosis of the acute abdomen in pregnant women by continual updating of abdominal assessment knowledge, and clinical skills is necessary in the management of abdominal pain in obstetric settings. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/204 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/204/199

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 8 3 2014 09 15 123 9 Roya Faraji Reproductive Health Research Center, Guilan University of Medical Sciences, Rasht, Iran. Seyedeh Hajar Sharami Reproductive Health Research Center, Guilan University of Medical Sciences, Rasht, Iran. Ziba Zahiri Reproductive Health Research Center, Guilan University of Medical Sciences, Rasht, Iran. Maryam Asgharni Reproductive Health Research Center, Guilan University of Medical Sciences, Rasht, Iran. Ehsan Kazemnejad Reproductive Health Research Center, Guilan University of Medical Sciences, Rasht, Iran. Shirin Sadeghi Reproductive Health Research Center, Guilan University of Medical Sciences, Rasht, Iran. 2015 10 16 https://jfrh.tums.ac.ir/index.php/jfrh/article/view/570 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/570/387

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 11 2 2017 10 28 104 109 EN Sumarah Sumarah Department of Midwifery, Poltekkes Kemenkes Yogyakarta, Daerah Istimewa Yogyakarta, Indonesia Hesty Widyasih Department of Midwifery, Poltekkes Kemenkes Yogyakarta, Daerah Istimewa Yogyakarta, Indonesia 2017 04 27 2017 06 25 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. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/602 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/602/388

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 11 2 2017 10 28 110 118 EN Mustafa Ansha Department of Public health, Debre Berhan Uni