fatemeh janani

High Body Mass Index (BMI) represents a significant global health challenge. This study aimed to investigate the relationship between gestational weight gain and depression during pregnancy and the postpartum period. Conducted as a descriptive-analytical study, it involved 115 pregnant women attending Shahid Akbar Abadi Hospital in Tehran. Data were collected using a demographic questionnaire and the Edinburgh Postnatal Depression Scale, both before during pregnancy, and the postpartum period. Data were analyzed using SPSS software, Pearson correlation, linear regression, and multivariate regression tests. A correlation was identified between changes in body mass index during pregnancy and maternal depression levels. The results of the logistic regression analysis indicated a significant association between increased body mass index during pregnancy and the likelihood of developing mental health disorders. These findings underscore the changes in body mass index during pregnancy, particularly in the third trimester, are associated with an elevated risk of maternal depression. Targeted interventions focusing on weight management and body image improvement may play a critical role in mitigating the risk of developing mental disorders.

Peripartum emergency hysterectomy is a major life-saving surgery that is almost always performed in cases of severe and life-threatening bleeding. This retrospective cross-sectional study aimed to determine the epidemiological characteristics of mothers who underwent peripartum hysterectomy between 2011 and 2019 in educational hospitals of Lorestan University of Medical Sciences, Iran. For this purpose, using a researcher-made information form, information on 150 peripartum hysterectomies was collected over a 9-year period based on the hospital records of the study units, and data analysis was performed using SPSS version 19 software and descriptive statistics of frequency, mean, and standard deviation. The incidence of peripartum hysterectomy has been reported to be 0.62 per 1000 births. In this study, the most common cause of peripartum hysterectomy was placental adhesions (60%) and uterine atony (54%), and 66% of peripartum hysterectomies were reported in individuals with a history of previous cesarean section. The mortality rate of mothers undergoing peripartum hysterectomy was 2%. This study showed that the rate of hysterectomy related to childbirth is similar to that in developed countries and lower than that in neighboring Asian countries. Placental adhesions and uterine atony were the most common causes of peripartum hysterectomy. Maternal death due to uterine rupture was reported in 2% of the study units. Reducing non-indicated cesarean sections, greater care in managed deliveries, and the need for skilled personnel in managing high-risk situations can reduce the rate of hysterectomies related to childbirth and, consequently, maternal mortality.

The present study aims to determine the relationship between maternal characteristics during pregnancy and postpartum cognitive function in mothers referring to health centers in Khorramabad, Iran. This descriptive-cross-sectional study was conducted on 400 mothers attending their first postpartum visit to health centers in Khorramabad during 2022-23. Data were collected using a demographic form and Addenbrooke's Cognitive Examination, and analyzed using SPSS version 25 software. Descriptive statistics and the calculation of central and dispersion indices were utilized to describe the data and provide quantitative variables. In addition, frequency and percentage were applied for qualitative variables. Independent t-tests, one-way analysis of variance, Pearson correlation, and univariate and multivariate linear regression were employed to analyze the data and determine the relationship between the variables. Finally, P≤0.05 was regarded as the significance level of the tests. A relationship was found between the mother's occupation and education demographic variables with the total cognitive function score (P<0.01). The results revealed that demographic characteristics such as occupation and education level affect postpartum cognitive disorder.

Femur fracture in newborn with breech presentation during cesarean section: A rare but possible complication Background Cesarean section is considered safer than vaginal delivery in risks involved for birth injury. Birth injury is more common in vaginal breech deliveries but is also encountered in Cesarean section. Although femur fracture is a relatively rare complication, it represents one of the most Common fractures of the lower extremity presenting in newborns. A 3780 g male infant was delivered at 38 weeks and 5 days by elective cesarean section for breech presentation. The newborn sustained a fracture of the right femur. A simple immobilization of the limb in extension led to a complete healing of the fracture without sequelae. Conclusion The objective of our case report is to increase awareness of clinical complication of femur fracture during breech extraction in course of cesarean section.Keywords: cesarean section, breech presentation, trauma, femur fracture

Intramuscular injections represent a painful procedure for premature infants. This study aimed to compare the effects of pressure massage at Hegu point versus Kunlun–Taixi pressure points on pulse rate, arterial oxygen saturation, and crying duration following intramuscular injection of vitamin K in premature infants.

Methods & Materials:

 A randomized, single-blind clinical trial was conducted on 100 premature infants admitted to the neonatal intensive care unit between 2020 and 2021. Participants were selected through convenience sampling and then randomly assigned into four groups of 25 individuals each: Hegu point massage, Kunlun–Taixi points simultaneous massage, placebo and control. Prior to the vitamin K injection, the intervention groups received targeted pressure point massage, the placebo group received nasal tip massages, and the control group received standard care. Pulse rate, arterial oxygen saturation, and crying duration were recorded before, during and after the intramuscular injection using a pulse oximeter and chronometer. Data were analyzed using two-way repeated measures analysis of variance in SPSS software version 24.

Significant differences were observed in average pulse rate (P=0.013) and average arterial oxygen saturation (P=0.028). The group receiving simultaneous massage at Kunlun–Taixi points exhibited the lowest mean pulse rates during (149.24±7.78) and after (144.16±8.64) the injection, as well as the highest mean arterial oxygen saturation percentages during (88.36±9.37) and after (88.04±8.33) the injection.

Simultaneous massage of Kunlun–Taixi pressure points reduced changes in pulse rate and arterial oxygen saturation induced by intramuscular injection in premature infants. It is recommended to use this simple and low-priced method to reduce the physiological responses to injection-related pain in premature newborns.

Nowadays, patients’ privacy as an important part of patient’s rights, which is related to his dignity, is regarded as the basis of treatment and care; and its significance as an ethical medical principle is on the increase. Therefore, the current research was conducted to investigate the preservation of patients’ privacy. This research is a cross-sectional descriptive study, conducted on 141 patients (with non-convenience sampling) admitted in the emergency department of Shahid Rahimi Hospital in Khoramabad. Data were collected using a three-part questionnaire investigating patients’ privacy. The results of this study revealed that the highest preserved cases in different dimensions of physical, information, and psychological - social privacy were: sitting on the patient’s bed with his permission), seeing parts of the body of other patients and respecting the values and beliefs of the patient by the medical staff. The most satisfaction case of patients was related to the refusal of the treatment staff from an unnecessary touch of the body and the least satisfaction case of patients was with hearing the conversation of other patients with the doctor or nurse unconsciously. Although the privacy of over half of the patients in terms of physical, information, and psychosocial dimensions was at acceptable level, yet, its observation is at very low level in terms of staff’s treatment ;thus, the managers, physicians, and nurses should pay more attention to this critical need.

Vitamin D deficiency is common during pregnancy and childbirth. Recent findings suggest that vitamin D deficiency is associated with adverse pregnancy outcomes. This study was performed to determine the association between low levels of maternal serum vitamin D and some adverse pregnancy outcomes such as premature rupture of embryonic membranes.

73 pregnant women with premature rupture of embryonic membranes as a case group 73 healthy pregnant women as control group were randomly selected from 18 to 35 pregnant women with a gestational age of 28 to 41, who had been referred to Asalian Hospital within 6 months, were selected. Blood levels of vitamin D were measured in both groups. Demographic information as well as data from laboratory results and patient histories were collected using a researcher checklist. Finally, patients were statistically evaluated for vitamin D levels and study factors.

The mean vitamin D level in patients with PROM was 22.49 7 ±7.25nm/lit and the mean vitamin D level in patients without PROM was 28.73 ±8. 8.72nm/l with p = 0.00. There was a significant relationship between vitamin D and PROM levels.

Based on the results of data analysis, it was found that there was a significant relationship between vitamin D levels and premature rupture of the amniotic sac. To examine more closely the relationship between maternal vitamin D levels and the occurrence of premature rupture of embryonic membranes, further research with a larger sample size and complete control of interfering factors is recommended.

Integration, is the combination of curriculum content areas, which is separate in traditional curriculum of educational system. This study aimed to investigate the viewpoints of faculty members of school of medicine about the horizontal integration of basic medical sciences. This was a qualitative content analysis study. The study population consisted of faculty members of Khorramabad School of Medicine, Lorestan University of Medical Sciences, Iran, and research environment was the school of medicine. Depth interviews with 7 faculty members, who played role in the application of horizontal integration of basic medical sciences, were done. At the end, interview transcripts were analyzed using Graneheim and Lundman content analysis method. Among the advantages of this plan was that a number of faculties preferred to teach based on integration method. Problems related to integration consisted of four categories, “problems related to the courses”, “professors’ problems”, “problems related to rules and regulations of the plan”, and “problems related to the courses”. According to our findings, it seems the program can be useful in medical education, but first, it should be revised, and related problems should be solved.

Sexual function plays an important role in strengthening the marital relationship. Sexual issues affect individuals’ quality of life. This study aimed to investigate the association between the sexual function and the quality of life among postpartum women in Iran.
For this cross-sectional descriptive study, 380 postpartum women who had referred to 10 urban health care centers in the west of Iran were chosen. They were recruited using the randomized cluster sampling method. A checklist for socio-individual and maternal status of women, female sexual function index (FSFI) and SF-36 questionnaire were used for data collection. Descriptive and inferential statistics were used for data analysis via SPSS software.
Most of the participants (76.3%) suffered from sexual dysfunction. Sexual desire was the most prevalent sexual dysfunction (79%). Moreover, the majority of the women achieved moderate scores in the subscales of the SF-36 questionnaire. The women with higher FSFI scores achieved higher scores in all SF-36 subscales. The Pearson correlation coefficient showed an appositive statistically significant linear correlation between the women’s general health and all dimensions of the FSFI except for pain during sexual relationships. The logistic regression analysis revealed that sexual function was a protective factor against the reduction of the quality of life, because quality of life was higher among the women with a higher level of sexual function compared to those with a lower sexual function (P Sexual dysfunction in the postpartum period could adversely affect the women’s quality of life. While sexual problems are very common in the postpartum period, they are not reported in most cases. Health care providers should design appropriate programs such as extended postpartum counseling for the women in the postpartum period.

Preterm delivery is one of the most common causes of perinatal mortality around the world. The purpose of this study was to determine the effect of clindamycin vaginal cream in the prevention of preterm labor.
This study was a control trial carried out on 236 pregnant women, referred to private practice office of a physician,with 13-20 weeks of gestational age. Samples of vaginal smear were gathered, and in the case of abnormal results, subjects were randomly assigned to either a control or case group. Clindamycin group treated with vaginal cream for three nights in the first turn and seven night at the second turn. But the control group received no treatment. Then, all subjects were followed up. Data wero collected using a questionnair and analyzed.
The incidence of premature birth in the control group was higher than the group under treatment with clindamycin (12% vs 7%), but this difference was not enough to be statistically significant. It was also shown that the higher incidence of preterm delivery in the control group was lower than the age of pregnancy termination. Mortality in the control group was significantly higher than the control group.
Although no significant difference was observed in the rate of preterm labor between the two groups, but in control group gestational age was less and mortality rate was high. It seems that clindamycin in decreasing prenatal mortality is associated with preterm labor effectively.

Evaluating the educational programs from the viewpoints of graduates may identify the weaknesses of such programs and provide the opportunity for their improvement. This study was performed to determine the appropriateness of educational programs for professional needs from the viewpoints of graduates of Khorramabad School of Nursing and Midwifery. This descriptive cross-sectional study was performed in the years 2006-2007 on 407 nursing and midwifery graduates who had graduated during 1999-2005. A questionnaire containing items about demographic data, appropriateness of educational programs objectives for professional needs, and factors influencing the quality of educational programs was sent to participants by mail and completed by them. The data was analyzed by SPSS software using descriptive statistics and Chi-square. Most of the nursing (72.9%) and midwifery (72.4%) graduates evaluated their competencies in taking care of patients as high. They also evaluated the training courses more effective on professional efficacy compared to practical and theoretical courses. From the graduate's points of view, the acquired skills during their academic years fulfilled their professional needs moderately, and lacking the essential skills made the nurses more strained than the midwives (37.1% and 22.4%, respectively). Factors affecting the quality of educational programs were reported by the graduates to be qualified faculty members and instructors, facilities for clinical education, educational environment, used teaching methods, educational facilities of the school, and the availability of scientific resources. professional needs of nursing and midwifery graduates are not fully covered by educational programs. It seems necessary to change the educational programs and provide required means and facilities in order to achieve the professional objectives and train skilled and productive human resources.

IUD is a useful and effective tool for family planning. Different kinds of this equipment are available at the market, but currently the most commonly used one in our country is CU T380A. Previous studies have shown that CU safe 300 is more effective and associated with less complications than CU t380A, thus it is more acceptable by users. The aim of this study was to determine and compare failure rate of CU T380A and CU safe 300 IUDS, four years after insertion. The present research is a cohort study carried out on 246 women who referred to health clinics of Khorramabad four years ago. These women divided into two equal groups. One group used CU T380A and the other group used CU safe 300. The rate of unwanted delayed complications such as spontaneous bleeding, pregnancy and spontaneous repelling of the IUDs were assessed by a questionnaire. Data were analyzed by Chi square and paired T test. Failure rate of CU T380A was more than CU safe 300. Statistical tests showed significant differences between these two groups. This study shows that new IUD (CU safe 300) which are smaller in size have less Failure rate and more acceptable by women, so their use is suggested in health clinics.

Women spend more than One – third of their life in postmenstrual period and more than 50% of them have urogenital problems in this period. The most common type of urinary incontinence in women is stress urinary incontinence and middle aged women are the most affected persons. We treated 93 menopaused women during 3 months. There were three groups and each group contained 31 patients. First group took Estrogen, the second group used Imipramine and the third group used estrogen in combination with Impramine. This study was a clinical trial and its main aim was verification of Estrogen effects on the treatment of stress urinary incontinence compared with Imipramine in menopaused women. We obtained information by using a questionnaire. The improvement percent of first group was 22.5% (7 patients). Improvement percent of second group was 54.8% (17 patients) and in last group was 70.9% (22 patients). Imipramine is more effective than Estrogen in treatment of stress urinary incontinence and combination therapy with these two drugs is not more effective than Imipramine alone.

Pre-eclampsia along with bleeding and infection constitute a triad that is a major cause of maternal mortality. Many factors have been recognized which can help us to determine the severity of the disease and early diagnosis of it. Since throphoblastic disorder is one of the etiological causes of pre-eclampsia, we decided to measure the level of β-hCG as a marker of detecting the activity of throphoblasts in normotensive, mild and sever pre-eclamptic pregnant women. This research was a cross - sectional study which carried out on 75 pregnant women admitted to Asali hospital. All patients matched for age and gravidity. Patients were divided into 3 groups: 25 cases of mild pre-eclampsia, 25 cases of severe pre-eclampsia and 25 cases of normotensive pregnant women. The level of β-hCG in each group was measured by ELISA assay. The level of β-hCG was 18572±2123 IU/L in normotensive group 23962±6558 IU/L in mild pre-eclamptic group and 59220±4634 IU/L in sever pre-eclamptic group. Statistical analysis by Kruskal-Wallis test showed that the level of β-hCG in severe pre-eclamptic group was significantly higher than the other two groups (p< 0/001). The level of the hormone was not significantly different in mild pre-eclamptic and normotensive. The level of in pregnant women with severe pre-eclampsia was more than the other two groups (Normotensive and mild pre-eclamptic). Therefore, higher levels of β-hCG can determine the severity of pre-eclampsia but is not valid marker for early detection of the disease.

Glucomanna appears to be useful as therapy for constipation in pregnancy and that is refractory to other treatment , such as increased dietary fiber intake or bulk laxatives. Materials &

To examine the effect of Glucomanna intake on constipation in pregnancy , which is predominant in the third trimester, 32 constipated pregnant women were treated with Glucomanna daily for 4WKQ in a clinical trial study. During the study, clinical efficacy was assessed using a daily diary . The subjects indicated the number of stools and the clinical symptom scores.

The mean number of stools was very low in the pre treatment week , and increased in weeks 1-4 of Glucomanna administration . The occurrence of very loose or very hard stools decreased and the stool consistency normalized. No side effects were observed.

Glucomanna intake was highly effective for the reduction of constipation in pregnant women.

University is a good scientific and cultural environment for the students to improve themselves in various social, educational and occupational grounds. This study was conducted to determine the effect of educational, student and cultural rules workshop on students knowledge and attitude in the university in 1383.

This is a semi – experimental study in which 106 students of all courses were participated explaining the research goals, knowledge and attitude were assessed in each classroom and a workshop was held to train all the university rules and laws by lectures and question answer method and then post – test was done. The collected data were analyzed using descriptive and analytic statistical tests.

54.7% of the participants were in the 2 years under graduate course , 26.4% in 4 years under graduate course and 18.9% were MD students. Mean age of students was 20 years and 8.6.8% them were female. Most students 55.7% had a mean score of 14.1-16.99 in the first term and 8.5% were accepted conditionally. Attention note was found in only 6.6% of conditional students record sheets. The mean knowledge scores of knowledge were higher before and, after the workshop k2 tests for attitude before and after the work shop was also different significantly p<0.05.

Training the students for educational student and cultural activities may improve the level of knowledge and attitude in these respects.

Preeclampsia is one of the most common complications of pregnancy. It is the cause of high morbidity and mortality for mothers and fetuses, especially in developing countries. The etiology of preeclampsia is unknown. One of the hypothesis on pathophysiology of preeclampsia is dyslipidemia. The aim of this study was to determine maternal plasma levels of lipoproteins in patients with preeclampsia and normotensive pregnants women who referred to Asali hospital. Plasma levels of total cholesterol, total triglyceride, low density lipoprotein (LDL) and high density lipoprotein (HDL) were measured in 20 preeclamptic women and 20 normal pregnant women with gestational age between 37-40 years. The plasma levels of total cholesterol and total triglyceride and low density lipoprotein (LDL) were significantly higher in preeclamptic women than in controls p<0.001). Levels of high density lipoprotein (HDL) did not differ significantly between two groups. The results indicate that dislipidemia is a risk factor for pathophysiology of preeclamsia.

Women suffer more often from depression than men. Social research suggests that high androgen levels cause aggressive behavior in men and women, and consequently cause depression. The purpose of this study was to determine serum levels of androgens, especially testosterone, in patients with depression. In this case-controlled study, we measured serum testosterone and dehydroepiandrosterone sulfate levels in 30 women with depression and 30 control subjects of the same age, weight, body mass index (BMI) and menstruation cycle. Total testosterone and free testosterone levels were significantly higher in patients with depression (202.3 ng/dl and 0.4 ng/dl respectively) than in the control group (140.3 ng/dl and 0.1 ng/dl respectively). There was no significant difference in dehydroepiandrosterone sulfate levels. This study may indicate a role of androgen, especially testosterone in the pathogenesis of depression.

Series studies have shown that complications vary based on the kind of IUD, and the smaller the size of IUD is the less the complications, such as bleeding and pain, will be. The aim of this study was to determine and to compare complications including bleeding, pain and etc in CU-T 380 A and CU Safe 300 IUDs users, three months after insertion. The present research is a clinical trial study carried out on 243 women demanding for IUD referred to Khorramabad health and treatment centers. Data were gathered using questionnaire and interview. Results showed that severity and prevalence of pelvic pain and spontaneously remove of IUD were more in CU-T 380 A group than that of CU safe 300 group. Statistical test showed significant differences between these two groups, but no significant difference was observed from view point of bleeding. This study shows that new IUDs (CU Safe 300) which are smaller in size have less complications and are in much demand by women, so utilizing this new IUD in health and treatment centers is suggested.