Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 9 1 2015 03 15 1 4 Elham Azimi Nekoo Tehran University of Medical Sciences, Tehran, Iran. Maryam Chamani Tehran University of Medical Sciences, Tehran, Iran. Ensieh Shahrokh Tehrani Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran. Batool Hossein Rashidi Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran. Fatemeh Davari Tanha Women's hospital, Tehran University of Medical Sciences, Tehran, Iran. Vahid Kalantari St Maarten School of Medicine, American University of Integrative Sciences, Cole Bay, St. Maarten. 2015 10 16 Objective: To investigate the reproductive outcome of artificial endometrial preparation with exogenous steroids for frozen-thawed embryo transfer with and without pre-treatment with depot gonadotropin releasing hormone agonist (GnRH-a) in women with regular menses. AMaterials and methods:This is a prospective randomized clinical trial conducted in two RT centers on 176 women undergoing frozen-thawed embryo transfer. All patients received oral estradiol valerate 4 mg daily from day 2 to day 5 and 6 mg per day from day 6 to the day of the pregnancy test. In day 13 of cycle, an ultrasound examination was performed. After ultrasound confirmation of endometrial thickness (≥8 mm) and no ovarian activity, progesterone in cyclogest supp (800 mg daily) was added. The dose of estradiol would be increased to 8 mg per day if the endometrial thickness was less than 8mm. Two or 3 embryos were transferred via transcervical route 48 hours after the beginning of progesterone administration. In group A (93 patients), Difereline (3.75 mg Im), as a depot GnRH agonist was administered in the midluteal phase (day 21) of previous cycle. In the other group B (n = 83) steroid supplementation was commenced without prior pituitary suppression. Chemical and clinical pregnancy rates were compared in two groups. Results:No significant differences were seen between two groups in terms of chemical pregnancy and clinical pregnancy rates. Conclusion:The findings support the artificial protocol without any pretreatment suppressive drugs to reduce the adverse side effects of GnRH agonists also to minimize the costs. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/221 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/221/216

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 9 1 2015 03 15 5 11 Maryam Bagheri Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran. Farnaz Sohrabvand Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran. Mahnaz Lankarani Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran. Zahra Zandieh Department of Anatomy, School of Medicine Sciences, Iran University of Medical Sciences, Tehran, Iran. Fedyeh Haghollahi Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran. Mamak Shariat Maternal-Fetal and Neonatal Health Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 16 Objective:To compared serum CRP levels and biochemical relation in PCOS patients with normal Iranian women. Materials and methods:This case-control study was performed on 52 individuals with PCOS (Rotterdam 2003 criteria). The cases were compared to 104 healthy non-PCOS, 20 to 35-year-old female subjects with no history of diabetes or renal diseases. Blood samples were taken on the 2(nd) to the 5(th) day of menstrual cycle for the evaluation of CRP levels, triglyceride, insulin, androstronedion, testestrone and total cholesterol. Results:The mean CRP was 1.38 (± 0.43) mg /dl in the PCOS group, and 1.08 (± 0.49) mg /dl (p= 0.240) in control group.High-Sensitivity C-Reactive Protein (HS-CRP) was positively correlated with the Body Mass Index (BMI) (r = 0.36, p= 0. 001). Before adjusting for age and BMI, CRP was correlated with LDL (r= 0.16, p= 0.03), total cholesterol (TC) (r= 0.17, p= 0. 03), Triglycerid (TG) (r= 0.23, p= 0.003), and the insulin (r= 0.20, p= 0. 01) notably in PCOS group. However, after adjustment was made for age and BMI, the correlation was attenuated in PCOS. The regression analyses depicted that CRP level was not under the influence of other medical parameters Conclusion: Conclusion:The results showed that mean CRP level was not significantly different between PCOs and normal women. After adjustment for age and BMI, CRP was not associated with any biochemical marker evaluated in this study. It seems that studied biochemical serum levels were mostly associated with obesity. So reduction of BMI may normalize the serum levels of CRP and other biochemical parameters. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/219 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/219/214

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 9 1 2015 03 15 13 18 Maryam Khooshide Department of Obstetrics and Gynecology, Arash Hospital, Tehran University of Medical Sciences, Tehran, Iran. Tiba Mirzarahimi Department of Obstetrics and Gynecology, Arash Hospital, Tehran University of Medical Sciences, Tehran, Iran. Ghodrat Akhavan Akbari Department of Anesthesiology Fatemi Hospital, Ardebil University of Medical Sciences, Ardebil, Iran. 2015 10 16 Objective:To compare the effect of the physiologic and facilitated labor on the mother and neonate outcomes in the prim gravid women referring to Arash Hospital. Materials and methods:This clinical trial study was performed on 200 low risk pregnant women referring to Arash Women's Hospital in 2012-2013. Mothers were divided into two groups of 100 patients using a simple random sampling method. The first group received the on-pregnancy and physiologic labor training and the second group was nominated for facilitated labor without training. The mother and neonate outcomes in these two delivery methods were then compared. Results:The rate of cesarean section in the physiologic group was significantly lower compared with the intervention group (p = 0.001). Also in the first stage of labor, VAS was measured to be noticeably lower in the physiologic group in comparison with the intervention group (p = 0.001), while the difference of VAS between the two studied groups was found not to be significant in the second stage of labor. In terms of duration of the labor and neonatal Apgar score two groups were not considerably different (p > 0.05). Moreover, the laceration rate in the physiologic group was determined to be noticeably higher as compared to the intervention group (p = 0.001). The groups were considerably different in terms of the vaginal bleeding and maternal satisfaction (p = 0.001). Conclusion: This study revealed the lower rate of cesarean section, abnormal vaginal bleeding and pain score in the physiologic group compared with the facilitated group. Moreover, mothers of the first group were more content with the labor process. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/217 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/217/212

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 9 1 2015 03 15 19 21 Mandana Mansour Ghenaee Guillan University of Medical Sciences, Rasht, Iran. Shaghayegh Rahmani Patient Safety Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Mina Jafarabadi Tehran University of Medical Sciences, Tehran, Iran. 2015 10 16 Objective:To evaluate the ability of lidocaine local injection to relieve postoperative pain in cesarean delivery. Materials and methods:This double blinded clinical trial was conducted in a university on 100 women underwent elective cesarean section during March 2012 till March 2013. Patients were divided to two groups with random block method (n = 50 in each group). First group received 4mg/kg lidocaine 2% and its volume was titrated to 30 cc with distilled water. Second group received 30 cc of normal saline. Injections were done in different layers of abdominal wall. Visual analogue scale (VAS) was applied to record 12 hours severity of pain in all patients. Data were analyzed by SPSS software using one way ANOVA parametric test. Results: VAS average was 4/13 in lidocaine group and 4/81 in placebo group. The need for analgesic use was 300 mg in lidocaine and 346 mg in normal saline patients and the difference was significant (p < 0.000). Conclusion:Local use of lidocaine 2% in cesarean incision reduced post operative pain and need to use analgesic agents. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/215 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/215/210

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 9 1 2015 03 15 23 28 Farideh Vaziri Department of midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran. Azam Hoseini Department of midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran. Farahnaz Kamali Department of midwifery, School of Nursing and Midwifery, Bushehr University of Medical Sciences, Bushehr, Iran. Khadijeh Abdali Department of midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran. Mohamadjavad Hadianfard Department of Physical Medicine and Rehabilitation, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran. Mehrab Sayadi Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. 2015 10 16 Objective:To compare the effects of aerobic and stretching exercises on severity of primary dysmenorrhea. Materials and methods:This randomized clinical trial was conducted on 105 female students who were suffering from primary dysmenorrhea. The participants were divided into aerobic exercise, stretching exercise, and control groups. The two intervention groups did the exercises three times a week for eight weeks (two menstrual cycles). The intensity of dysmenorrhea was determined using a modified questionnaire that assessed several symptoms of dysmenorrhea. After all, the data were compared between and within groups through analysis of variance. Results:Before the intervention, the mean intensity of dysmenorrhea was 40.38 ± 5.5, 37.40 ± 3.8, and 38.45±3.3 in aerobic, stretching, and control groups, respectively, but the difference was not statistically significant. After the intervention, however, a significant difference was found among the three groups regarding the mean intensity of dysmenorrhea in the first and second menstrual cycles. Also, a significant difference was observed between the aerobic group and the control group as well as between the stretching group and the control group. Within group comparisons showed a significant difference in the aerobic and the stretching group before and after the interventions. However, no such difference was observed in control group. Conclusion:Both aerobic and stretching exercises were effective in reducing the severity of dysmenorrhea. Therefore, women could choose one of these two methods with regard to their interest and lifestyle. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/213 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/213/208

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 9 1 2015 03 15 29 33 Seyed Mohamad Mireskandari Department of Anesthesiology, Tehran University of Medical Sciences, Tehran, Iran. Khalil Pestei Department of Anesthesiology, Tehran University of Medical Sciences, Tehran, Iran. Asghar Hajipour Department of Anesthesiology, Tehran University of Medical Sciences, Tehran, Iran. Afshin Jafarzadeh Department of Anesthesiology, Tehran University of Medical Sciences, Tehran, Iran. Shahram Samadi Department of Anesthesiology, Tehran University of Medical Sciences, Tehran, Iran. Omid Nabavian Department of Anesthesiology, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 16 Objective: To study the role of preoperative intravenous magnesium sulphate in decreasing post-cesarean pain and opioid requirement during first 24hrs. Materials and methods: In a double blind randomized clinical trial, prior to induction of general anesthesia, fifty elective cesarean candidates were randomly assigned to one of the two groups of placebo or magnesium sulfate. After surgery visual analogue scale (VAS) and infused morphine by PCA during 24 hrs were recorded. The data were analyzed by mann-Whitney -test, analysis of variance, and student t- test. Results: VAS was significantly lower among patients in the magnesium sulphate group at intervals of 1(st), 6(th) & 12(th) hours after cesarean section (C/S) with the mean scales of (48.9 ± 19.6 VS 74.7 ± 18.4), (42.1 ± 0.9 VS 58.3 ± 16.5) and (25.2 ± 6.1VS 30 ± 8.1) respectively and p-value of < 0.001, 0.002 and 0.05 respectively. However at 24 hrs there was no significant difference in VAS with mean VAS scales of 22.6 ± 4.5 VS 23.6 ± 4.9 and p-value of 0.49. The dose of infused Morphine during 24 hrs was significantly less in the magnesium sulphate group than the placebo group with the means of 4.36 ± 1.4 VS 7.02 ± 1.9 mg respectively (p < 0.001). Conclusion: Administration of bolus 50 mg/kg magnesium sulphate prior to induction of general anesthesia may significantly decreased the morphine requirement during immediate post operative period and can be recommended as one of the modalities of post-operative pain control in the pregnant patients. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/211 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/211/206

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 9 1 2015 03 15 35 40 Monoarul Haque Department of Community Nutrition, Faculty of Public Health, Bangladesh University of Health Sciences (BUHS) Dhaka, Bangladesh. Sharmin Hossain Department of Health Promotion & Health Education, Bangladesh University of Health Science (BUHS), Dhaka, Bangladesh. Kazi Rumana Ahmed Department of Health Promotion & Health Education, Bangladesh University of Health Science (BUHS), Dhaka, Bangladesh. Taslima Sultana Department of Public Health, Stahe 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. 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 Universit