International Journal of Women’s Health and Reproduction Sciences
Volume:10 Issue: 2, Apr 2022

Breastfeeding self-efficacy (BFSE) is considered one of the critical components of a successful breastfeeding experience. The purpose of this study was to review the educational interventions to improve BFSE.

The Cumulative Index to Nursing and Allied Health Literature, Web of Science, ProQuest Nursing and Allied Health Source, PubMed, EMBASE, Social Science Research Network, SCOPUS, Health and Psychosocial Instruments, PsycINFO, Mosby’s Nursing Skills, SID, Magiran, Google Scholar, Iran Medex, and Iran Doc databases were searched. Eligible articles were published from January 2000 until December 2019. Two independent reviewers conducted data extraction and relevance screening.

Out of 287 studies, 25 of them were eligible for review. Modalities of interventions were summarized into three types: Visual aids (e.g., booklets, pamphlets, handouts, posters, and movies), verbal education (e.g., instruction by health providers, peer educators, group educational sessions, or small group and face-to-face education), and telephone support.

Interventions included procedures specifically had offered for increasing maternal BFSE. The findings demonstrate the importance of designing educational programs to improve mothers’ BFSE

The present study systematically reviewed the literature on the effects of menopausal symptom management aids on knowledge, decision conflict, and satisfaction about menopause-related symptom management.

All clinical trial and quasi-experimental studies published in English-language from 1990 to 2021 were searched in CINAHL, PROQUEST, Web of Sciences, Google Scholar, PubMed, and Scopus databases. In addition, we used the Ovid search interface for MEDLINE, Embase, CENTRAL, and Cochrane Library. The effect of interventions on continuous outcomes, including knowledge, decisional conflict, and decisional satisfaction, with a standardized mean difference (SMD), was reported in the present study. The included studies were assessed for statistical heterogeneity by using the I2 test and examining the P value.

The results indicated the limited effect of the decision aid-based intervention on the decisional conflict, satisfaction with the decision, and knowledge. However, it is worth mentioning that the findings indicated high heterogeneity among the studies reviewed in the present study.

In the previous studies, the decision aid booklets used mostly provided limited and incomplete information on the available strategies to alleviate the symptoms perceived in menopause, so design and conduct a study with a strong, robust methodology and a comprehensive decision

This study aimed to highlight the influence of surgical experience in performing the abdominal hysterectomy and improving the linear curve of skills.

This retrospective study was conducted on 245 women who underwent hysterectomy at Jordan University Hospital, Amman, Jordan, from January 2017 to 2019. The gravidity, parity, age, body mass index, the cause and type of the hysterectomy, duration of surgery, need to blood transfusion, estimated blood loss, time of hospital stay, intraoperative and postoperative complications, and the histopathology results were extracted from records of the participants and analyzed.

This study showed that the leading cause of hysterectomy in participants was abnormal vaginal bleeding. The most common type of hysterectomy was simple abdominal hysterectomy with a mean operation time of 1 hour 12 minutes. In total, 25.6% of women received packaged red blood cells, the main cause of which was preoperative anemia (17.5%). These results reflect an improvement in the linear curve of learning surgical skills.

Our results portrayed the improvement of the surgical technique gained through performing abdominal hysterectomy expressively leading to a lessening in operative time compared with time while using a traditional technique, a decline in the total cost of surgery, and a decreased number in the surgical threads used in each operation. Surgical expertise can be appraised via many clinical parameters; mean operative time, complication rates, and other outcome measures. The expansion of surgical skills and the steadfastness of the medical team were a direct cause of these results.

 The present study aimed to assess the significance of human epididymis protein 4 (HE4) and cancer antigen 125 (CA 125) in the overall survival (OS) and the recurrence survival of endometrial cancer.

The study was conducted on 99 patients with a mean age of 53±64. The patients were all cases with a definitive diagnosis of endometrial cancer. With regard to the histology and the surface measurement, the HE4 and CA 125 were both confirmed within 1 to 2 week(s) prior to hysterectomy by implementing the standard-procedure treatment of extra facial total hysterectomy and bilateral salpingo-oophorectomy with selective pelvic and para-aortic node dissection. Then, risk-assessment for possible recurrence (Mayo criteria) was carried out as well. Patients with the variables of HE4 and CA 125 in the upper third (66th) percentiles were grouped as high-risk. Finally, the data were analyzed using SPPS 23, and P <0.05 was considered statistically significant.

The mean (SE) of OS among patients with the serum CA 125 of ≤22 kU/L and higher 22 kU/L was 47.97 (±2.58) and 41.78 (3.75) months (P = 0.466). In addition, the mean (SE) of OS in patients with the serum HE4 level of ≤ 98 ρmol/L and >98 ρmol/L was 50.14 (2.06) and 38.54 (3.74), respectively. The log-rank test revealed a substantial difference between low- and high-risk groups by HE4 ( χ2=4.98, P = 0.025). Accordingly, there is no significant difference between recurrence-free survival (RFS) with CA 125 (P = 0.264) and HE4 ( P = 0.114), respectively.

In general, the serum HE4 level is a significant independent prognostic factor for OS in endometrial cancer and is useful in survival studies.

Neural tube defects (NTDs) are caused by inadequate closing of the neural tube. Alpha-fetoprotein has limitations due to its poor sensitivity and specificity in NTD detection. Proprotein convertase subtilisin/kexin type 9 (PCSK9) appears to have an escalating role in neurogenesis. This study aimed to evaluate the two forms of PCSK9 (Mature PCSK9 and furin cleaved) circulating in NTD maternal sera as a potential novel non-invasive biochemical marker for prenatal screening of NTDs.

In this case-control study, the presence of PCSK9 in serum samples of 30 pregnant women with current NTD fetuses (case group) and 30 pregnant women with a healthy singleton pregnancy (control group) was evaluated by Western blot analysis followed by the immuno-precipitation approach.

Median of mature PCSK9/furin ratio among the case group was 0.92 (0.05-2.54) versus 1.29 (0.19-6.62) among the control group (P = 0.02). Receiver operating characteristic curve analysis for mature PCSK9/furin ratio displayed a sensitivity and specificity equal to 63.3%.

The ratio of mature PCSK9 to furin cleaved form was significantly reduced among women with current NTD fetuses compared to women having healthy pregnancies. This ratio can be a potential original biochemical marker in the non-invasive prenatal screening of NTDs.

In developing countries, treatment of cervical cancer with metastasis to the spinal cord is generally associated with failure and reduced patient survival due to the lack of appropriate facilities. Oncologists are using a variety of methods to prolong patient survival. In the present study, we aimed to estimate the three- and five-year disease-free survival of patients with cervical cancer and spinal cord metastasis, treated with external radiotherapy + brachytherapy (i.e., internal radiotherapy.

This descriptive cross-sectional study was performed over a period of ten years (2010-20) in the brachytherapy ward of Shahid Madani Hospital (Tabriz, Iran). Overall, 200 patients with cervical cancer and spinal cord metastasis who were candidates for external radiotherapy + brachytherapy were recruited by the census sampling method. The variables that were likely to affect survival were recorded and analyzed using the Koch survival test and relevant descriptive and inferential statistics in SPSS version 23 software.

The patients’ overall survival was 43.12 ± 1.44 months; 78 patients (39%) survived until the end of the third year, and 49 (24.5%) lived till the end of the fifth year. Also, the pathological diagnosis (P = 0.013- P = 0.015), disease stage (P = 0.014- P = 0.018), the length of the treatment area (P = 0.026- P = 0.044), and undergoing chemotherapy (P = 0.001- P = 0.002) were significantly associated with the survival of the patients who completed the treatment course.

Chemotherapy, advanced disease, and greater length of the treatment area reduced three- and five-year survival in the patients with cervical cancer and spinal cord metastasis who underwent brachytherapy.

Considering that the prevalence of infertility in Iran is higher than the world average and there is no system for recording these individuals’ data, this study aimed at designing and validating infertility data recording tools in Iran.

This questionnaire study was conducted in Tabriz in 2019. Five areas were prepared for the questionnaire (i.e., in vitro fertilization or intracytoplasmic sperm injection, intrauterine insemination, ovulation induction) and treatment outcomes) and used after reviewing the studies. The Delphi quantitative technique was applied to standardize and validate the questionnaire through evaluating five infertility specialists. The content validity index (CVI), content validity ratio (CVR), and coefficient of agreement (Cohen’s kappa coefficient) were employed to assess content validity through a quantitative approach. Finally, the reliability of the questionnaire was evaluated using the Kuder-Richardson formula through the evaluation of 50 infertile couples visiting AL-Zahra specialized and super-specialized hospital in Tabriz.

The CVI and CVR of all items were calculated and obtained greater than 0.8 except for items 8, 17, and 18 and thus were identified as appropriate items in the questionnaire. Kappa coefficients (k) were also calculated and found to be greater than 0.8 for all items except for the three above-mentioned items. The items with lower than an acceptable CVI, CVR, and k were modified, and the k of the total items was obtained as 0.95. Eventually, the reliability of the questionnaire and its domains were assessed, and the reliability coefficient of the questionnaire was higher than 0.64, which was acceptable.

A questionnaire was designed to evaluate the history and clinical problems of infertile couples with 5 domains and 61 items to record their information (desirable validity and reliability) in their clinical records.

Today, infertility is a global complication affecting 8%-12% of couples. The use of assisted reproductive techniques (ARTs) gives couples to have taken the home baby chance. In this study, we compare the outcomes of the ARTs after using the standard dose of human chorionic gonadotropin (hCG) hormone and gonadotropin-releasing hormone (GnRh) agonist plus declined dose of hCG for final oocyte maturation in antagonist cycles.

This randomized clinical trial was conducted in Al-Zahra hospital, Tabriz, Iran from June to December 2019 on 100 infertile women who were candidate for in vitro fertilization in two groups: group A received standard dose of hCG and group B received GnRH agonist 0.2 mg and hCG 2500 international unit as dual trigger. The number of oocytes retrieved, embryo obtained, implantation rate, pregnancy rate, and ovarian hyperstimulation syndrome (OHSS) were compared between two groups.

The number of retrieved oocytes in the group B was more than group A (P = 0.024), and the embryo obtained in both groups was similar. The implantation and pregnancy rate in the group B increased compared to group A (P = 0.001). There was no OHSS case in the group B, while in the group A two cases suffered from OHSS.

Dual trigger with GnRH agonist plus declined hCG dose increased the number of retrieved oocytes, implantation, and pregnancy rates and decreased the risk of OHSS compared to standard hCG trigger. The gynecologists should select the best strategy based on the patient’s condition.