The effect of hyoscine n- butylbromide on labor progress: A systematic review

Background

The objective of this systematic review and meta-analysis was to assess the effectiveness of hyoscine n-butylbromide in labor progress.

Methods

The databases including PubMed, the Cochrane Library, Science-Direct, Scopus and Web of Science were searched for studies published up to December 2019. Articles that published as randomized controlled trials (RCTs), and full-text articles published in English or other languages were included and participants were primi or multigravida women who were in active phase of labor. The intervention included HBB compared to placebo (normal saline) that was used during active phase of labor. Pooled estimates were measured using the fixed or random effect model, while the overall effect was reported in a mean difference (MD). All data were analyzed using Review Manager 5.3.

Results

Twenty studies involving 3108 women were included in meta-analysis. Based on subgroup analysis by parity, use of HBB significantly reduced the duration of the first stage of labor in primigravida women (MD = − 57.73; 95% CI: [− 61.48, − 53.60]) and in multigravida women (MD = − 90.74; 95% CI: [− 97.24, − 84.24]). Administering HBB could reduce the second stages of labor in primigravidas and multigravidas about 6 min and 4 min respectively. Also, HBB reduced the duration of the third stage of labor in multigravidas about 3 min. APGAR score at one and 5 min after birth was not affected. The main maternal adverse effect was tachycardia and dry mouth. Labor duration in studies in which the participants were primi-and multigravida was not presented based on separate parities except for four papers, and the route of HBB administration was not the same across all studies.

Conclusions

Although, the effect of HBB was minimal when multigravidas and primigravidas women were considered together, the HBB was clinically effective in primigravida and multigravida women for shortening the first and the second stages of labor. Also, HBB could reduce the length of the third stage of labor in multigravidas.

Upregulated miR-410 is linked to poor prognosis in colorectal cancer

BACKGROUND

Although miR-410 acts as a cancer inducer in colorectal cancer, there is limited data on the clinical implications of miR-410 expression levels in patients. We hypothesized a link between miR-410 expression and its potential clinical values in patients with colorectal cancer.

MATERIAL AND METHODS

120 colorectal cancer tissue specimens and 120 adjacent non-tumour tissues were obtained. Quantification of miR-410 expression levels was determined by, quantitative RT-PCR. Expression was analysed by clinical features.

RESULTS

miR-410 was up-regulated in malignant tissues compared with corresponding normal tissues (P < 0.01), with TNM stage and lymph node metastasis (P = 0.03, P = 0.004, respectively), and with worse overall survival (P = 0.002). Multivariate survival analysis identified it as an independent risk factor for outcome (P = 0.021, HR = 2.19; 95% CI = 1.12-4.25).

CONCLUSION

Compared to normal non-cancerous tissues, miR-410 was overexpressed in tumour tissues and is independently associated with the unfavourable outcome. Levels of MiR-410 might a useful laboratory tool in managing and predicting the prognosis of colorectal cancer.

The Impact of Oxytocin Vaginal Gel on Sexual Function in Postmenopausal Women: A Randomized Controlled Trial

Many postmenopausal women suffer from sexual dysfunction mostly due to the vulvovaginal atrophy. The aim of this study was to assess the effect of vaginal oxytocin gel on sexual function of postmenopausal women. This study was conducted on 96 postmenopausal women with symptoms of vaginal atrophy and sexual dysfunction who were randomly recruited into two groups of oxytocin vaginal gel (400 IU, n = 48) or placebo (n = 48). The PH, vaginal maturation index, and sexual function (using Female Sexual Function Index) of the participants were measured at the beginning of the study and eight weeks later. The vaginal maturation index and the PH of the vagina improved in the oxytocin group compared to those of the placebo. All domains of sexual function including desire, arousal, lubrication, pain, sexual satisfaction, and total score of sexual function improved significantly in the oxytocin gel compared to the control group (p < 0.0001). The results of this study showed that the administration of oxytocin vaginal gel could significantly improve vaginal atrophy as well as sexual function in postmenopausal women. Therefore, using vaginal oxytocin gel for sexual dysfunction in postmenopausal women who are not interested in hormone therapy is recommended.

A case of gastrointestinal tuberculosis with unusual manifestations of carcinomatosis

Unusual manifestations of TB may include gastrointestinal symptoms such as abdominal pain, constipation, and IVC thrombosis. These symptoms may be misdiagnosed for carcinomatosis. According to our study even with medical advances, the diagnosis of GI TB is still enormously difficult.

Secnidazole for treatment of bacterial vaginosis: a systematic review

Background

Bacterial vaginosis (BV) is one of the common vaginal infections among childbearing women. The usual treatment for BV is metronidazole; hence 30% of women have recurrence within 60 to 90 days after treatment. There are some studies which assessed the effect of secnidazole on BV. The aim of this systematic review was to investigate the effectiveness of secnidazole for treatment of BV.

Methods

The Cochrane Library, MEDLINE (PubMed), Scopus, and Web of Science (all databases from inception till October 28, 2018) were searched. Primary outcomes were clinical cure rate and microbiologic cure rate and the secondary outcomes were adverse events. Data was extracted from eligible studies by two review authors individually and analyzed by RevMan 5.3.

Results

Our search found six trials involving 1528 participants. Treatment with 2 g secnidazole could significantly reduce the risk of BV in patients with three or less episodes of BV in the last year by OR: 7.54 (95% CI, 3.89–14.60, p < 0.00001) and in patients with four or more episodes of BV in the last year (OR: 4.74, 95% CI: 1.51–14.84, p = 0.0.008). Secnidazole (2 g) could significantly increase the microbiologic cure rate in women with 3 or less episodes of BV in the last year (OR: 7.63, 95% CI: 2.30–25.33, p = 0.0009) but not in the women with 4 or more episodes of BV in the last year (OR: 20.17, 95% CI: 1.06–382.45, p = 0.05). The clinical cure rate, microbiological effect and the therapeutic cure rate of 2 g secnidazole was significantly more than that of 1 g secnidazole.

The results showed that the clinical cure rate of 2 g secnidazole was not different from the following medications: metronidazole (500 mg bid for 5 days), secnidazole plus vaginal metronidazole, 2 g single dose of oral metronidazole and 2 g secnidazole plus vaginal ornidazole.

Conclusion

This review showed that 2 g and 1 g secnidazole were better than placebo, however, 2 g secnidazole was more effective than 1 g. Secnidazole 2 g was not different from metronidazole (500 mg bid for 5 days), or from secnidazole plus vaginal metronidazole, or 2 g single dose of oral metronidazole or from 2 g secnidazole plus vaginal ornidazole.

Sex hormone binding globulin for prediction of gestational diabetes mellitus in pre-conception and pregnancy: A systematic review

AIM

The purpose of the present study was to assess the relationship of sex hormone binding globulin (SHBG) and gestational diabetes mellitus (GDM).

METHODS

The Cochrane Library, Medline, ScienceDirect, and Web of Science were searched for studies published from the inception of the databases up to February 2019. Our inclusion criteria were published observational full-text articles. All data were analyzed using Review Manager 5.3. Of 208 papers reviewed, 26 studies (n = 6668) were considered for meta-analysis.

RESULTS

The SHBG level was significantly lower in women with GDM compared to healthy women (MD = -11.86; 95% CI: [-13.02, -10.71]). Also, SHBG in women with PCOS and GDM and obesity was significantly lower than women with PCOS without GDM (MD = -38.14; 95% CI: [-56.79, -19.48]) and normal weight women (MD: -58.96; 95% CI: [-79.32, -38.59]). SHBG in the second trimester was lower than that in the first trimester and pre-conception.

CONCLUSIONS

This systematic review showed that the level of SHBG is significantly lower in GDM pregnant women than that in healthy women. The results of this systematic review about the relationship of GDM and SHBG and suggestion to assess this marker in early pregnancy should be considered with caution.

Visual Cues and Food Intake: Distortion Power of Plate and Spoon Size on Overweight and Obese University Staff

Background:

This study was designed to evaluate the effect of the size of plate, spoon, and fork on food and energy intake during a meal in obese or overweight staff.

Methods:

This was a crossover randomized controlled trial that was conducted on 40 obese or overweight clerical staff of the university. The staff was invited to have lunch randomly, receiving either a large or a small set of plate, spoon, and fork. Washout period was 3 weeks, and the participants were then invited to have lunch in a second intervention period and received opposite sizes of dishes compared to the first period sizes. The meal was composed of roasted chicken (kebab), cooked rice, vegetable salad, dairy drink, and soda. Changes in food intake between large and small utensils (plate, spoon, and fork) were analyzed with paired t-test.

Results:

Rice intake using small or large eating utensils was different (P = 0.02). But total energy intake was not different. The Pearson correlation test demonstrated a positive and significant correlation between rice consumption and waist-to-hip ratio (P = 0.02). Soda (P = 0.02), carbohydrate (P = 0.01), and total energy intake (P = 0.03) were negatively correlated with the age of the participant.

Conclusions:

It seems that only the amount of grain products consumption changes with changing in dishware size with no significant effect on total energy intake. It is recommended that the independent effect of visual cues on food intake for foods with different textures be investigated in future studies.

The relationship between sleep quality and lifestyle in postmenopausal Iranian women: a cross-sectional study

One of the most frequent symptoms in postmenopausal women is sleep disturbance. This study aimed to determine the relationship between sleep quality and lifestyle factors in postmenopausal women. Postmenopausal women (n = 252) in Ahvaz, Iran with an age range of 45-55 years, were enrolled from April to December 2015. The study tools included the Lifestyle Questionnaire (LSQ) and Pittsburgh Sleep Quality Index. The LSQ contains 10 lifestyle factors: physical health, physical activity, weight control and nutrition, psychological health, spiritual health, social health, medications and narcotics avoidance, illness prevention, accident prevention, and environmental health. Data were analyzed using, chi-square, Pearson correlation coefficients, analysis of variance, and multiple linear regressions. In unadjusted analyses, physical health, physical activity, nutrition, mental health, spiritual health, social health, and medication and narcotics avoidance scores were significantly higher in women without sleep disruption than in those with light and moderate sleep disruption (p < .001). Adjusting for confounding factors, sleep disruption was directly related to duration since the final menstrual period (p < .001), and inversely related to physical health (p = .04) and spiritual health (p = .028). Lifestyle factors were related to sleep disruption in postmenopausal women. Policymakers should consider education on healthy lifestyles for women.

Prevalence and related factors of postpartum depression among reproductive aged women in Ahvaz, Iran

In this study authors aimed to identify the prevalence and related factors of postpartum depression in Ahvaz, Iran. A total of 505 women enrolled in this study from six public health centers in Ahvaz city, Republic of Iran. This study started in February and completed in September 2014. Data was gathered using a socio-demographic and Edinburgh Postnatal Depression Scale Persian version. Authors screened women from 14 days to 6 months postpartum. Mothers with a score of >12 were classified as a postpartum depression (PPD). Our results revealed that 196 individuals (38.8%) had PPD. Women with PPD had significantly more of the following characteristics: undesired pregnancy, neonatal hospitalization, congenital abnormalities, history of postpartum depression, history of lifetime episode of depression, stressful events during pregnancy and an experience of domestic violence during pregnancy (p < 0.05). Our results showed that congenital abnormalities (OR = 2.99, 95% CI: 1.44-5.90), history of PPD (OR = 2.61, 95% CI:1.53-4.44), a lifetime episode of depression (OR = 3.26, 95% CI: 1.63-6.49) and having stressful events in the last year (OR = 4.1, CI: 2.19-7.80) were significantly contributed to the PPD. PPD is a common health problem among mothers and screening should be performed after childbearing to identify mothers at the risk.

The Relationship Between Vitamin D and Postpartum Depression in Reproductive-Aged Iranian Women

Background: The aim of this study was to evaluate the relationship between vitamin D and postpartum depression in reproductive-aged Iranian women.

Methods and Results: This study was conducted on 120 women (60 with postpartum depression and 60 without) in Izeh, Iran. A socio-demographic questionnaire and Beck Depression Scale were used for data collection. The ELISA method was used for measuring 25-OH vitamin D (ng). The participants were classified according to their vitamin D level as follows: 25-OH-D < 10ng/ml considered as severe deficiency, 10–20n g/ml as moderate insufficiency, 20–30 ng/ml as mild insufficiency and >30ng/ml as normal. Data were analyzed using the independent t-test or Mann-Whitney test, chi-square and logistic regression test. The mean level of vitamin D of women with postpartum depression was lower than that in normal women (16.89±7.05 vs. 21.28±7.13, p=0.001). More than 53% of women with postpartum depression had vitamin D <20 ng/ml compared to 31.7% of women with no depression (p=0.005). Moreover, 16.7% of women with postpartum depression had vitamin D < 10ng/ml compared to only 6.7% in the normal group (p = 0.005). Women with vitamin D less than 20ng/ml compared to vitamin D > 20ng/ml were 3.30 times more likely to have postpartum depression (OR: 3.3, CI: 1.32–8.24, p= 0.01).

Discussion: There is a significant relationship between a low level of vitamin D and postpartum depression among reproductive-aged Iranian women. Health policy makers should pay attention to the measuring vitamin D level as one of the primary tests of pregnant women.

The effect of carbetocin compared to misoprostol in management of the third stage of labor and prevention of postpartum hemorrhage: a systematic review

BACKGROUND

Postpartum hemorrhage (PPH) and the amount of blood loss are directly related to management of the third stage of labor. No previous report has compared the effects of carbetocin to those of misoprostol. The aim of this systematic review was to compare the effects of carbetocin to those of misoprostol for management of the third stage of labor and for the prevention of PPH.

METHODS

We searched the Cochrane Library (Central), Web of Science, Scopus, Science Direct, Ovid, clinicaltrial.gov , and PubMed databases on December 28, 2017. Data extraction and risk of bias assessment were performed by 2 of the authors independently. Individual and pooled incidences were calculated for the included studies, with 95% confidence intervals (CIs). We used a fixed model for forest plots without heterogeneity and a random effect model for those with heterogeneity.

RESULTS

Our search identified 117 studies; however, 29 studies were duplicate. Of the 88 non-duplicate studies, 5 met the inclusion criteria. Of these five studies, two are currently underway. Hence, three studies were finally included in our meta-analysis. The pooled estimate of the impact of carbetocin on PPH (500-1000 ml) was (OR 0.27, 95% CI 0.14-0.50). Carbetocin significantly reduced the need for additional uterotonics (RR 0.28, 95% CI 0.15 to 0.49). Reduction in the hemoglobin level and blood loss during the third stage of labor was significantly lower in women who received carbetocin than in those who received misoprostol. The length of the third stage of labor was significantly lower in women who received carbetocin than in those who received misoprostol. The incidence of side effects, such as heat sensation, metallic taste, fever, and shivering, were significantly lower in women who received carbetocin than in those who received misoprostol.

CONCLUSION

Although this review showed that carbetocin is effective for decreasing PPH, blood loss, the length of the third stage of labor, and the need for additional uterotonics, this conclusion should be considered with caution. Because assessment of PPH is a subjective issue and it is uncertain whether outcomes were assessed blindly in respect to treatment. We recommend future research to verify our findings. Also clinicians may like to consider use of carbetocin for women with low risk for PPH.

Comparison of Training via Short Messages and Group Training on Level of Knowledge and Practice of Middle-Aged Women About Breast Cancer Screening Tests

This study is aimed to compare the effect of two methods of short messages and group training on level of knowledge and practice of middle-aged women about breast cancer screening procedures. This clinical trial study was done on 210 women aged 40-60 years in Mahshahr city, Iran. Eligible middle-aged women were randomly assigned in two groups of short message (n = 105) and group training (n = 105). Data collected through a questionnaire which included three parts (demographic, knowledge and practice of women about breast cancer and screening procedures). Group training was educated for two sessions in 2 weeks that each session lasted 2 h. In the short message group, every woman received texts about breast cancer, reasons, and preventive methods, three times a week, for 2 weeks. The questionnaire (knowledge and practice) was completed 2 months after educational intervention. Data was analyzed using independent t test, paired t test, and chi-square. Results of this study showed that average score of knowledge in two groups increased significantly, from 34.4 ± 7.54 to 40. 8 ± 7.18 in the short text messages (SMS) and from 35 to 39.75 in the group training (P > 0.05). Also, the score of breast examination by health provider in the SMS group was significantly higher than that in the group training, but the score of breast self-examination in the group training was higher than that in the short message (P < 0.05). The results showed that training by each way is effective to increase knowledge and performance of women about breast cancer screening methods. Further studies to compare the cost-effectiveness of two methods are recommended.

Comparison of the effect of breast pump stimulation and oxytocin administration on the length of the third stage of labor, postpartum hemorrhage, and anemia: a randomized controlled trial

BACKGROUND

This study aimed to compare the effect of breast pump stimulation with that of oxytocin administration regarding the duration of the third stage of labor, postpartum hemorrhage, and anemia after delivery.

METHODS

In this study, 108 women were randomly assigned to two groups of breast pump stimulation (n = 54) and oxytocin administration (n = 54). Women in the breast stimulation group received breast pump stimulation (10 min intermittently for each breast with a negative pressure of 250 mmHg), while the women in the oxytocin (control) group received an infusion of 30 IU oxytocin in 1000 mL of Ringer's serum with a maximum rate of 10 mL infusion per min after delivery. The duration of the third stage of labor, blood loss during the third stage of labor and 24 h after delivery, hemoglobin and hematocrit (before and 24 h after delivery), after-birth pain, and the number of breastfeedings during the 24 h after delivery were recorded. The data were analyzed using the chi-square test, independent t-test, and Wilcoxon test.

RESULTS

The mean duration of the third stage was 5 ± 1.97 and 5.4 ± 2.5 min in the breast stimulation and women that received intravenous oxytocin respectively (p = 0.75). Most participants had mild postpartum hemorrhage (98.1 and 96.2% in the breast stimulation and women that received intravenous oxytocin, respectively, p = 0.99). Although hemoglobin and hematocrit levels significantly decreased in both groups 24 h after delivery, there was no significant difference between both groups regarding both parameters. After-birth pain was significantly lower and the number of breastfeeding during the 24 h after delivery was significantly more in the breast stimulation group compared to the control group.

CONCLUSIONS

Our results demonstrated no differences between breast pump stimulation and oxytocin administration regarding the duration of the third stage of labor, postpartum hemorrhage, anaemia, after-birth pain, and the number of breastfeedings during the 24 h after delivery.

TRIAL REGISTRATION NUMBER

The study protocol was registered in the Iranian Randomized Controlled Trial Registry (Ref. No.: IRCT2015050722146N1 ; Registration date: 2015-11-04). The study was registered prospectively and the enrollment date was 23/8/2015.

A comparison of the effects of Lawsonia inermis (Iranian henna) and clotrimazole on Candida albicans in rats

BACKGROUND

Candida albicans may cause vaginal infections in women. The aim of this study was to compare the antifungal effect of Lawsonia inermis with that of clotrimazole on rats.

METHODS

A total of 35female Wistar rats were randomly assigned into 5groups. Four groups were infected vaginally with C. albicans and one group was not (negative control). The four infected groups received the following treatments: two groups received vaginal creams of 2% or 4% of L. inermis, one group received 1% clotrimazole and one infected group did not receive any treatment (positive control). The hydro-ethanolic henna extract was prepared from the powder of henna leaves using maceration method. Samples were taken for culture from the vaginae of all rats before the treatment, one and two weeks after treatment. An ANOVA test was used to analyze the data.

RESULTS

Before the treatment, the mean colony forming units (CFU) was 213.6±10.08 and 334.42±20.32 in the 2% and 4% henna groups, respectively, 312.7±28.32 in the clotrimazole group, 233.85±8.15 in the positive control group, and zero in the negative control group. The mean CFUs were zero for all groups except for the 2% henna and positive control groups (P<0.001) one week after the treatment and zero in all groups except for the positive control group two weeks after the treatment (P<0.001).

CONCLUSION

L. inermis (henna) in form of vaginal cream could treat C. albicans infections in female rats; however, 4% henna was more effective and had an effect similar to that of clotrimazole.

The prevalence of restless legs syndrome and its relationship with demographic characteristics and medical disorders in postmenopausal Iranian women

This study was conducted to evaluate the prevalence of restless legs syndrome (RLS) and its relationship with demographic factors and medical disorders on 980 postmenopausal women. Data was gathered using a demographic questionnaire and the International Restless Legs Syndrome Scale. The prevalence of RLS was 16.02% (157/980). Women with poor economic status were 3.37 and 2.33 times more likely to have RLS than women with a good economic situation and moderate economic status (CI:2.041-5.579, P ≤ 0.0001) and (CI: 1.540-3.551, P ≤ 0.0001) respectively. The risk of RLS was 64% greater in women who smoked than in non-smokers. Women with history of hypertension, diabetes and anemia were 2.82, 2.09 and 2.19 times, respectively, more likely to have RLS than those without (P < 0.001). Also women with higher body mass index were more likely to have RLS and women taking hormone replacement therapy were less likely to have RLS. The prevalence of RLS among postmenopausal Iranian women is quite high and there is a relationship between RLS and factors such as age at menopause, education level, a history of smoking, hypertension, anemia and diabetes.

The effect of Calendula officinalis versus metronidazole on bacterial vaginosis in women: A double-blind randomized controlled trial

Bacterial vaginosis (BV) is a common disorder among women of reproductive age. This study aimed to compare the effect of a Calendula officinalis extract-based cream and metronidazole on BV among women of reproductive age. In this study, 80 women of reproductive age with BV were randomly assigned to the C. officinalis (n = 40) or metronidazole (n = 40). Diagnosis of BV was confirmed when at least 3 of the 4 Amsel criteria were met (pH >4.5, whitish grey or thin homogeneous discharge, release of a fishy odor on adding 10% KOH, and detection of clue cells on microscopic examination). For each group, either a methanol extract of C. officinalis or metronidazole vaginal cream (5 g) was used for 1 week intravaginally, and all signs and symptoms were assessed 1 week after treatment completion. Before the intervention, the two groups did not differ significantly with regard to vaginal burning, odor, dysuria, and dyspareunia, but itching was significantly more common in the C. officinalis group than in the metronidazole group (22.5% vs. 2.5%, P = 0.01). One week after the intervention, all women in both groups were free of symptoms, including vaginal itching and burning sensation, odor, dysuria, and dyspareunia. None of the women in either group suffered any side effects from C. officinalis or metronidazole. C. officinalis was effective for the treatment of BV in women of reproductive age, without any side effects. This herb could be recommended for women of reproductive age who uncomfortable with the potential side effects of synthetic drugs.

Effect of fennel vaginal cream on sexual function in postmenopausal women: A double blind randomized controlled trial

Objective: The aim of this study was to assess the effect of fennel on sexual function in postmenopausal women. It was a randomized controlled trial in 60 postmenopausal women with sexual dysfunction who were randomly assigned to two groups receiving either fennel vaginal cream (n=30) or placebo (n=30). Vaginal atrophy in the women was assessed using symptoms such as pallor, dryness, dyspareunia, itching and burning. The pH of the vagina and cytology of the vaginal mucosa were also measured at baseline and 8 weeks after the intervention. All participants were requested to fill out the Female Sexual Function Index (FSFI) at baseline and after 8 weeks. The intervention group was requested to use fennel vaginal cream (5 grams) every night, while the control group used placebo each night for 8 weeks. The data were analyzed using the independent t-test and Chi-square, Mann-Whitney and Wilcoxon tests. All areas of sexual function including arousal, lubrication, orgasm, sexual satisfaction and pain improved in both fennel and placebo groups after 8 weeks; however, the differences in the fennel group were more evident (p<0.05). The total FSFI score was significantly higher in the fennel group compared to the control group (8.2 ±9.4 and 8.03±10.36 before the intervention and changing to 33.79±0.7 and 18.99±1.09 after the intervention in the fennel and placebo groups, respectively; p<0.001). Discussion: According to our results, fennel vaginal cream is an effective means of improving sexual activity in postmenopausal women. The use of this product in women who have sexual dysfunction and contraindications for hormone therapy is recommended.

Psychometric properties of the Iranian version of mindful eating questionnaire in women who seeking weight reduction

BACKGROUND

The aim of the present study was to test the validity, reliability and factor structure of the original Mindful Eating Questionnaire (MEQ) for use in an Iranian population.

METHODS

This was a cross-sectional study conducted on 150 women who attended four athletic gyms and met the inclusion criteria in Ahvaz city in July of 2015. After linguistic validation of the Iranian version of the MEQ, the content validity ratio (CVR) and content validity index (CVI) were assessed by an expert panel. Then, exploratory factor analysis (EFA) was performed on the scale constructs and scale reliability (internal consistency and test-retest reliability) was assessed with respect to the psychometric properties of the scale.

RESULTS

The CVR and CVI scores for the MEQ were 0.89 and 0.93, respectively. EFA loaded all 28-items with a 5-factor solution ('awareness', 'distraction', 'disinhibition', 'emotional response' and 'external cues') that jointly accounted for 53.78% of the observed variance. The results of the EFA supported the item 'When a restaurant portion is too large, I stop eating when I'm full' being placed in the external cues rather than the disinhibition subscale. This displacement improved the reliability coefficient for this subscale.The results of internal consistency analysis, including Cronbach's alpha (ranging from 0.73 to 0.81) and intraclass correlation coefficients (ranging from 0.73 to 0.91) were satisfactory.

CONCLUSIONS

The Persian version of the MEQ appears to be valid and reliable; therefore, it can be an effective tool in designing mindfulness-based interventions for the treatment of individuals with eating disorders, overweight and obesity in an Iranian population.

The Effect of Auriculotherapy on Labor Pain, Length of Active Phase and Episiotomy Rate Among Reproductive Aged Women

Objective: This study aimed to evaluate the effect of auriculotherapy on labor pain, the length of the active phase, and episiotomy rate among reproductive aged Iranian women. Materials and methods: In this study, 80 women were assigned to two groups: auriculotherapy (n = 40) and control group (n = 40). Auriculotherapy was performed in the earlobe in the Zero, Shen Men, Uterus, Pelvic, Abdomen, Spleen, External genitalia, and Master cerebral regions in the cervix dilation of 4, 6, and 8 cm between uterine contractions. The control group received routine hospital care. The labor pain, duration of the active phase, and rate of episiotomy were assessed in two groups. The independent t- test and chi-square were used for statistical purposes. Results: The mean of labor pain during the active phase was 7.56 ± 0.83 in the auriculotherapy group and 8.43 ± 0.69 in the control group (p < 0.001). The length of active phase was significantly lower in the auriculotherapy than that in the control group (176.2 ± 1 min vs. 342.8±87.2 min, p < 0.001). The rate of normal vaginal delivery (without an episiotomy or perineal tears) was significantly higher in the auriculotherapy group than that in the control group (50% vs. 2.5%, p < 0.001). Conclusion: Auriculotherapy is safe, cost effective and devoid of side effects to reduce the labour pain, length of the active phase and the rate of episiotomy in nulliparous women. This method can be considered as a complementary medicine in labour.

How does health-promoting lifestyle relate to sexual function among women of reproductive age in Iran?

This study aimed to evaluate the relation between health-promoting lifestyle and sexual function among women of reproductive age. In this cross-sectional study, 1200 women were recruited randomly from 10 public health centers in Ahvaz, Iran. A demographic questionnaire, Health Promoting Lifestyle Profile 2 (HPLP2), and Female Sexual Function Index (FSFI) were used for data collection. The inclusion criteria were as follows: women aged 15-45 years, married, monogamous, and having basic literacy. Data were analyzed using Kruskal-Wallis test, chi-square test, Spearman correlation coefficient, and logistic regression. All aspects of sexual function showed a significant relationship with different dimensions of HPLP2, except for pain and physical activity ( p < 0.001). Women who had better self-actualization were more likely to have better sexual function than other women (OR = 1.10, 95% CI: 1.06-1.14, p < 0.001). Other variables like responsibility, interpersonal relations and stress management also showed a significant correlation with sexual function. Results of this study showed that health-promoting lifestyle dimensions are significantly related to all aspects of sexual function in women of reproductive age. Health policy makers should take lifestyle-related factors of reproductive-aged women into account when seeking to improve the sexual wellbeing of this population. Further attention should also be given to assessing the direction of causality.

Relationship between delivery modes and genitourinary syndrome among postmenopausal women

OBJECTIVES

Many postmenopausal women suffer from genitourinary syndrome of menopause (GSM) due to the lack of estrogen. This study aimed to evaluate the relationship between mode of delivery and GSM among postmenopausal women.

METHODS

We performed a case-control study of women who had had either vaginal delivery or Cesarean section. Data were collected through a sociodemographic questionnaire and a check list for assessing signs and symptoms of GSM. Subjective symptoms of vaginal atrophy (dryness, dyspareunia, itching, burning and paleness), pH of the vagina and maturation index were assessed and recorded. Data were analyzed using the χ² test and independent t-test.

RESULTS

A total of 125 postmenopausal women were recruited (65 with a history of normal vaginal delivery (NVD) and 60 with a history of Cesarean section). Vaginal pH was more commonly lower (pH 5-5.49) in the NVD group (50.8% vs. 40%) (p < 0.001). The maturation index was also better in the NVD group (42.7 ± 6.34 vs. 24.08 ± 8.2) (p < 0.001). All symptoms of vaginal atrophy including paleness, dryness, itching, dyspareunia and burning were significantly less in the NVD group compared to the Cesarean section group (p < 0.05).

CONCLUSION

Postmenopausal women with a history of normal vaginal delivery were less likely to have GSM compared to the women with a history of Cesarean section. Other prospective studies can explore this relationship better.