BackgroundThere is evidence that traumatic birth experiences are associated with psychological impairments. This study aimed to estimate the prevalence of childbirth-related post-traumatic stress symptoms and its obstetric and perinatal risk factors among a sample of Iranian women.MethodsThis was a cross-sectional study carried out in Bushehr, Iran during a 3-months period from July to September 2009. Data were collected from all women attending eleven healthcare centers for postnatal care 6 to 8 weeks after childbirth. Those who had a traumatic delivery were identified and entered into the study. In order to assess childbirth-related post-traumatic stress, the Post-traumatic Symptom Scale-Interview (PSS-I) was administered. Data on demographic, obstetric and perinatal characteristics also were collected. Multivariate logistic regression was performed to examine the association between childbirth-related post-traumatic stress and demographic and obstetric and perinatal variables.ResultsIn all, 400 women were initially evaluated. Of these, 218 women (54.5%) had a traumatic delivery and overall, 80 women (20%) were found to be suffering from post-partum post-traumatic stress disorder (PTSD). Multiple logistic regression analysis revealed that post-partum PTSD was associated with educational level, gestational age at delivery, number of prenatal care visits, pregnancy complications, pregnancy intervals, labor duration, and mode of delivery.ConclusionsThe findings indicated that the prevalence of traumatic birth experiences and post-partum PTSD were relatively high among Iranian women. The findings also indicated that obstetric and perinatal variables were independently the most significant contributing factors to women’s post-partum PTSD. It seems that a better perinatal care and supportive childbirth might help to reduce the burden of post-partum PTSD among this population.

BackgroundZingiber officinale R. rhizome (ginger) is a popular spice that has traditionally been used to combat the effects of various inflammatory diseases. The aim of this study was to evaluate the effects of ginger on pain relief in primary dysmenorrhea.MethodThis was a randomized, controlled trial. The study was based on a sample of one hundred and twenty students with moderate or severe primary dysmenorrhea. The students were all residents of the dormitories of Shahed University. They were randomly assigned into two equal groups, one for ginger and the other for placebo in two different treatment protocols with monthly intervals. The ginger and placebo groups in both protocols received 500 mg capsules of ginger root powder or placebo three times a day. In the first protocol ginger and placebo were given two days before the onset of the menstrual period and continued through the first three days of the menstrual period. In the second protocol ginger and placebo were given only for the first three days of the menstrual period. Severity of pain was determined by a verbal multidimensional scoring system and a visual analogue scale.ResultsThere was no difference in the baseline characteristics of the two groups (placebo n = 46, ginger n = 56). The results of this study showed that there were significant differences in the severity of pain between ginger and placebo groups for protocol one (P = 0.015) and protocol two (P = 0.029). There was also significant difference in duration of pain between the two groups for protocol one (P = 0.017) but not for protocol two (P = 0.210).ConclusionTreatment of primary dysmenorrhea in students with ginger for 5 days had a statistically significant effect on relieving intensity and duration of pain.Trial registrationIRCT201105266206N3

BackgroundThe aim of present study was to determine disease-related and psychological risk factors for sexual dysfunction in women with multiple sclerosis (MS).MethodsThis was a clinical-based study conducted from September 2009 to June 2010 in Tehran, Iran. A consecutive sample of female patients with MS was recruited from an outpatient clinic. The Female Sexual Function Index (FSFI) was used to evaluate sexual function. In addition neurological impairment was measured using the Kurtzke Expanded Disability Status Scale (EDSS), and depression was assessed using the Beck Depression Inventory-II (BDI-II). Univariate and multiple logistic regression analyses were performed in order to examine the association between sexual dysfunction and independent variables.ResultsIn all, 226 women participated in the study. Of these, 125 women (55.3%) met the criteria for sexual dysfunction. The mean age of participants was 35.7 years (SD = 8.07). The results obtained from multiple logistic regression analysis indicated that the disease duration (OR for the disease duration of equal or greater than 9 years = 3.13, %95 CI = 1.29-7.57, P = 0.01), the disease course (OR for secondary progressive MS = 3.96, %95 CI = 1.55-10.10, P = 0.004) and the BDI score (OR = 1.11, %95 CI = 1.07-1.16, P < 0.001) were significant factors contributing to sexual dysfunction in these patients.ConclusionsThe findings from this study indicated that the duration and severity of the disease in addition to depression were the most significant factors that contributed to sexual dysfunction in women with multiple sclerosis. The burden of disease and sexual dysfunction suggests the need for further attention to this patient population.

Later admission in labor increases the rate of spontaneous vaginal delivery in low risk nulliparous women.

BackgroundChildbirth by cesarean section has increased at an alarming rate over the past few years in Iran. The present study was designed to explore pregnant women’s beliefs about the mode of delivery in order to provide some suggestions for future interventions to increase vaginal delivery.MethodsThis was a qualitative study framed by the Theory of Planned Behavior conducted in Tehran, Iran in 2013. Pregnant women attending public hospitals were recruited. The data were collected via in-depth interviews and focus group discussions. Interviews were conducted in a semi-structured manner. All interviews were tape recorded and transcribed verbatim. A content analysis approach was used to explore the data.ResultsIn all 36 pregnant women participated in the study. The mean age of women was 27.8 (SD = 4.5) years. In general, women preferred vaginal delivery. During interviews and focus group discussions several themes emerged related to the pain associated with vaginal delivery, fears of childbirth, related health concerns, and the role of decision makers. The findings were grouped into three main themes namely: behavioral beliefs (negative and positive beliefs towards outcomes of vaginal delivery), normative beliefs (injunctive norms and descriptive norms), and control beliefs (internal and external barriers).ConclusionDespite the fact that there were positive beliefs regarding vaginal delivery, participants indicated concerns related to loss of control and fear. It is essential that health care providers realize the psychological needs of women during pregnancy and the need for continuous support during childbirth. This type of support may improve their self-control during labor, and decrease fear of childbirth.

BackgroundSexual desire and frequency of sexual relationships during pregnancy remains challenging. This study aimed to assess factors that affect women’s sexual functioning during pregnancy.MethodsThis was a cross sectional study carried out at prenatal care clinics of public health services in Iran. An author-designed structured questionnaire including items on socio-demographic characteristics, obstetric history, the current pregnancy, and women’s sexual functioning during pregnancy was used to collect data. The generalized linear model was performed in order to find out factors that affect women’s sexual functioning during pregnancy.ResultsIn all, 518 pregnant women participated in the study. The mean age of participants was 26.4 years (SD = 4.7). Overall 309 women (59.7 %) scored less than mean on sexual functioning. The results obtained from generalized linear model demonstrated that that lower education, unwanted pregnancy, earlier stage of pregnancy, older age, and longer duration of marriage were the most important factors contributing to disturbed sexual functioning among couples.ConclusionThe findings suggest that sexual function during pregnancy might be disturbed due to several factors. Indeed issues on sexual relationship should be included as part of prenatal care and reproductive health programs for every woman.

Background:The 12-Item General Health (GHQ-12) questionnaire is one of the most commonly used instruments in screening studies on mental health.Objectives:The current study aimed to examine the factor structure of the GHQ-12 questionnaire among the students in Iran.Materials and Methods:It was a cross-sectional study in which 428 university students were recruited and completed the GHQ-12. Reliability of the GHQ-12 was evaluated using the Cronbach's alpha and the split-half method by applying the Spearman-Brown coefficient. Factor structure of the questionnaire was extracted by exploratory factor analysis (EFA). Confirmatory factor analysis (CFA) was conducted to assess how well the EFA extracted model fitted the observed data.Results:The mean age of the participants was 22.83 years (SD = 3.09). Most of them were female (56.1%) and 81% were unemployed. The Cronbach’s alpha coefficient for the Iranian version of GHQ-12 was 0.85. Using the split-half method, the alpha for the social dysfunction was found to be 0.77; it was 0.76 for the psychological distress. The principal component analysis revealed a two-factor structure for the questionnaire including social dysfunction and psychological distress that explained 48% of the observed variances. The confirmatory factor analysis was showed fit for the data.Conclusions:The current study findings confirm that the Iranian version of GHQ-12 has a good factor structure and is a reliable and valid instrument to measure psychological distress and social dysfunction.

Objectives:We evaluate the level of anxiety and depression among patients with spinal cord injury (SCI) in relation with their religious coping and spiritual health. Setting: Brain and Spinal Cord Injury Repair Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Methods: A sample of patients with SCI participated in this cross-sectional study. They completed a sociodemographic questionnaire, the Hospital Anxiety and Depression Scale, the Brief Religious Coping Questionnaire and the Spiritual Well-being Scale. Then, the association between anxiety, depression and independent variables was examined. Results: In all, 213 patients with SCI were studied. Of these, 64 (30%) have had anxiety and 32 (15%) have had depression. Multiple logistic regression analyses revealed that gender (odds ratio (OR) for female = 3.34, 95% confidence interval (CI) = 1.31-8.51, P = 0.011), employment (OR for unemployed = 5.71, 95% CI = 1.17-27.78, P = 0.031), negative religious coping (OR = 1.15, 95% CI = 1.04-1.28, P = 0.006) and existential spiritual well-being (OR = 0.93, 95% CI = 0.89-0.97, P = 0.003) were significant contributing factors to anxiety (Table 3), whereas negative religious coping (OR = 1.21, 95% CI = 1.06-1.37, P = 0.004) and existential spiritual well-being (OR = 0.90, 95% CI = 0.84-0.96, P = 0.001) were significant contributing factors to depression. Conclusion: The findings indicated that depression and anxiety are two psychologically important side effects after SCI. The findings also indicated that religion and spiritual well-being have a moderating role on occurrence of depression and anxiety.