مجله زنان مامائی و نازائی ایران
سال پانزدهم شماره 11 (هفته اول امرداد 1391)

As for increasing the rate of cesarean section, its cost and limited resources in our country, this study was done aimed on assessing demographic factors and background variables as predictors of cesarean section. This cross sectional study was conducted on 2124 term pregnant women referred to Isfahan hospitals in May 2009. Sampling method was census. Data were collected and analyzed using SPSS software version 15 and logistic regression model. P value less than 0.05 was considered statistically significant. Women who had one or two children compared to nulliparous, age equal or higher than 20-35 compared to age less than 20, having education and job, admitted in private hospital and women who covered by various insurances had more elective cesarean section. The odds ratios in all of them were significant (p<0.05). Women with high eco-social level and also having insurance in pregnancy period can consider as predictive factors for elective cesarean section.

Premenstrual syndrome is one of the most common problems of women that may lead to decrease of academic and job performances and impairment of interpersonal relationships. Therefore, it is essential to use some interventions to resolve this problem. The purpose of this study was to investigate the effects of Group Cognitive-behavioral/narrative therapy of premenstrual syndrome of female students of Shahid Chamran University in Ahvaz. This experimental field research with pretest and post test was done on 40 female students living in dormitories with the mean age of 23 years (±3.25). They were selected randomly among 73 volunteer female university-students with premenstrual syndrome who were eligible for inclusion. The participants were placed randomly in control and case groups. Two groups completed demographic questionnaire and Daily Rating Severity of problems in pre-test. Case group participated in ten sessions of 90-minute of group therapy per week. Then, Post test and follow up were taken from both groups. Obtained data were statistically analyzed by multivariate analysis of covariance. P value less than 0.05 was considered statistically significant. The result of covariance analysis showed that Group Cognitive-behavioral/narrative therapy has decreased total scores of premenstrual symptoms (p<0/001) and its subscales (p<0/001) in the case group compared to the control group in post-test and follow up stage. Group Cognitive-behavioral/narrative therapy has an effective role in decrease of premenstrual syndrome.

Tubal sterilizing is a permanent and most popular method of contraception in US. However, it might have some side effects such as an increase of hysterectomy. This study is aimed to investigate the relationship between tubal ligation and hysterectomy. It was a case-control study in which the case group was consisted of women underwent hysterectomy surgery at Imam Reza Hospital and Patients of control group were those who underwent surgery for Cystocele, Rectocele and Perineal tear. The required data were collected from patient's files and were analyzed by STATA (version 8), using univariante and multivariante logistic regression. P value less than 0.05 was considered statistically significant. Controlling all factors, the present study showed that factors such as age, previous abortion and tubal ligation significantly increase risk of next hysterectomy. Menopause did not have any significant relation with risk of hysterectomy. Causes of hysterectomy in case group were abnormal uterus bleeding (68%), myoma (9.6 %) and other causes (adenomyosis, endometriosis, chronic pelvic pain (22.4%)). In both groups, tubal ligation and use of combined oral contraceptive pills were the most common contraception methods. Their average age at the time of tubal ligation was 36.3± 5.8 in case group and 34.6 ± 5.5 in control group (P= 0.057). No significant relation was found between menopause and increasing risk of hysterectomy in this study. Our study showed that there was a significant relation between tubal ligation and increasing risk of next hysterectomy. Previous abortion was recognized as a risk factor for hysterectomy.

Several studies have reported the positive effect of resistance exercise on reproductive tract, but the efficacy of aerobic training with and without curcumin supplementation, especially during simultaneous exposure to chronic contamination with lead, has not been studied. So this study was done aimed on investigating the effects of simultaneous and separate endurance training and curcumin antioxidant supplementation on normal sperm count, sperm motility and reproductive hormones in lead-exposed rats. In this experimental study, 60 male Wistar rats were divided into six groups (10 rats/group): base, sham, lead, exercise-lead, curcumin-lead and exercise-curcumin-lead. Training protocol was performed for groups 3 and 6 include progressive running on a treadmill without incline for 8 weeks and 5 sessions in a week, with 15 to 22 meters per minute and duration 25 to 64 minutes. In addition, curcumin supplement was injected 30 mg per kg of body weight peritoneally 3 days per week and totally 8 weeks for groups 4 and 6, curcumin solvent for group 2 and 20 mg/kg lead for all groups (except groups 1 and 2). We assessed follicle stimulating, testosterone and LH hormones and also motility and morphological profile of sperm by standards methods. The testis and epididymal MDA were measured by TBARS method, respectively. After measurement of reproductive hormones, sperm motility and morphology were analyzed using ANOVA and SPSS software (version 13). P less than 0.05 was considered significant. Lead induction caused non-significant reduction of testosterone (p=0.885), follicle stimulating hormone (p=0.128), luteinizing hormone (p=0.981), and non-significant increase in MDA of testis (p=0.095) and epididymis (p=0.15) compared to treatment groups. Lead injection caused non-significant reduction of sperm motility and normal sperm count in lead treated group compared to other groups (p=0.228, p=0.087, respectively). However, doing aerobic exercises and curcumin antioxidant inhibit harmful effects of lead exposure on these parameters. Air pollution exposure has unfavorable effects on reproductive system, but regular aerobic exercises and antioxidant supplement are suitable guidelines to inhibit negative effects of pollutants but do not improve the quality and quantity of reproductive indicators.