مجله دانشکده پزشکی اصفهان
پیاپی 687 (هفته سوم آبان 1401)

People with gender dysphoria have a noticeable discrepancy between their assigned gender and their experienced/expressed gender. This study aims to know the understanding and experience of parents of people with gender dysphoria about their child's condition.

With the available sampling method, interviews were conducted with 15 parents of gender dysphoria referred to Ibn Sina Hospital in Mashhad in 2019. Strauss and Corbin method was used for data analysis. A semi-structured interview was conducted. MAXQDA software was used to organize and code qualitative data.

In total, 15 interviews and 121 conceptual codes were extracted. About 58% of children with gender identity disorder were girls. The average age of these people at the time of participation in the study was 24 years, the mean age since deciding to perform surgery was 21 years, and the average age of onset of symptoms in childhood was 9 years. The findings obtained in this study, in six central categories with the titles as follows: parents' experience since the childhood of a child suffering from gender dysphoria, unusual behaviors observed in adolescence of a person with gender dysphoria from the perspective of parents, parents' feelings, parents' misbehavior, the causes of this from the parents' point of view, the problem with the individual's own experience of gender identity disorder.

Considering the expression of parents' experiences and knowledge of the many challenges between families and children in this regard, in order to improve the quality of life and improve the mental health of people suffering from gender dysphoria, the need for educational interventions at general and specialized levels seems necessary.

One of the most common complications of surgery is postoperative pain that Lack of control of this pain causes complications such as ileus, pulmonary atelectasis and increased hospital stay. The goal of this clinical trial was comparison of the effect of ibuprofen and piroxicam on pain relief after lower abdominal surgery and the amount of opioid used after surgery.

In a clinical trial, 90 patients undergoing lower abdominal surgery were distributed among three groups of 30 people. First group received 1cc intramuscular piroxicam and 4cc intravenous normal saline, second group received 4cc intravenous ibuprofen and 1cc intramuscular normal saline and third group received 1cc intramuscular and 4cc intravenous normal saline. Pain intensity after full consciousness and at 2, 8, 12 and 24 hours after surgery, the amount of opioid used in the first 24 hours and patients' satisfaction with pain relief after 24 hours were recorded.

The mean of pain intensity at 2 (P = 0.016), 8 (P < 0.001) and 12 hours (P = 0.018) after surgery in the three groups was significantly different but the pain intensity, after consciousness (P = 0.605) and at 24 hours (P = 0.331) was not significantly different between three groups. The amount of consumed opioid was significantly different between three groups (P < 0.001).

Ibuprofen and piroxicam are effective in reducing postoperative pain and opioid consumption after lower abdominal surgery but their effects are not different.

Evidence has shown that the COVID-19 pandemic can have unpleasant side effects for pregnant women and fetuses. Therefore, vaccination of pregnant women was performed to make this group safe. In order to consolidate the existing knowledge about the effectiveness and consequences of pregnancy in women who underwent this vaccination, this study was designed and implemented.

In this systematic review study, all published studies up to 24.2.2022 were included in the study. The studies were searched in the databases of Embase, PubMed, Web of Science, Scopus using the keywords Pregnancy, COVID-19 Virus Vaccines, Pregnancy Complications and fetal outcome. The two researchers independently reviewed the articles for quality assessment (using the Newcastle-Ottawa tool) and extracted their main findings.

In this review study, 10 studies were included in accordance with the inclusion criteria with 40522 pregnant women who received the COVID-19 vaccine. The incidence of maternal complications after vaccination was extremely low. Among pregnant women, there was no significant difference in maternal complications based on whether the vaccine was given in the first, second or third trimester of pregnancy. Covid-19 vaccination during pregnancy was not associated with an increase in pregnancy complications or delivery.

Considering that the safety and efficacy of COVID-19 vaccine are important factors in achieving population immunity, more acceptance of vaccines is essential to achieve adequate immunization coverage. Health care providers can use the available data to educate and empower pregnant women to make informed decisions.