Comparing the Effects of Aerobic and Stretching Exercises on the Intensity of Primary Dysmenorrhea in the Students of Universities of Bushehr

Objective: To compare the effects of aerobic and stretching exercises on severity of primary dysmenorrhea. Materials and methods: This randomized clinical trial was conducted on 105 female students who were suffering from primary dysmenorrhea. The participants were divided into aerobic exercise, stretching exercise, and control groups. The two intervention groups did the exercises three times a week for eight weeks (two menstrual cycles). The intensity of dysmenorrhea was determined using a modified questionnaire that assessed several symptoms of dysmenorrhea. After all, the data were compared between and within groups through analysis of variance. Results: Before the intervention, the mean intensity of dysmenorrhea was 40.38 ± 5.5, 37.40 ± 3.8, and 38.45±3.3 in aerobic, stretching, and control groups, respectively, but the difference was not statistically significant. After the intervention, however, a significant difference was found among the three groups regarding the mean intensity of dysmenorrhea in the first and second menstrual cycles. Also, a significant difference was observed between the aerobic group and the control group as well as between the stretching group and the control group. Within group comparisons showed a significant difference in the aerobic and the stretching group before and after the interventions. However, no such difference was observed in control group. Conclusion: Both aerobic and stretching exercises were effective in reducing the severity of dysmenorrhea. Therefore, women could choose one of these two methods with regard to their interest and lifestyle

The Effect of Aromatherapy by Lavender Oil on Infant Vaccination Pain: a Double Blind Randomized Controlled Trial

Introduction: Exposure to noxious stimuli can cause pain in infants. This study was conducted to evaluate the effects of the lavender oil inhalation on the pain resulting from the pentavalent vaccination. Methods: This clinical trial consisted of two groups: the lavender oil group with 42 infants and the placebo group with 57 infants. The healthy infants without congenital abnormalities in need of pentavalent vaccine also participated in our study. The infants started the lavender oil or placebo aromatherapy one minute before injection. The pain was assessed three times, using the Neonatal Infant pain Scale (NIPS): before vaccination, 15 s, and 5 min after vaccination. Also, the duration of crying was measured in both groups. Results: At baseline, the two groups were similar in relation to the NIPS scores. While, after 5 minutes, the NIPS score was significantly lower in the lavender group. Based on the repeated measures analysis, the NIPS score changed over time totally. However, the two groups were significantly different in relation to the NIPS score over time. The duration of crying was 75.47 (60.675) second in the lavender group and 105.22 (75.739) s in the control group. The statistical test showed a significant difference between the two groups. Conclusion: A low concentration of the lavender oil inhalation can reduce the pain and improve soothing in the infants with the pentavalent vaccine injection

Human Herpesvirus-6 and Human Herpesvirus-7 Infection in Iranian Patients with Neurological Illness

Human herpes virus-6 (HHV-6) and HHV-7 have been implicated as causes of meningitis and encephalitis in children and adults. In this study the presence HHV-6 and HHV-7 DNA were tested in cerebrospinal fluid (CSF) sample taken from Iranian children, suffered from meningoencephalitis. From 2007 to 2009, 150 patients from Tehran with meningoencephalits who were referred to a pediatric ward in Rasoul Akram hospital, Tehran Iran, were enrolled in the present study. Conventional and BACTEC Ped Plus medium were used in conjunction with latex agglutination test and real time PCR for detection of HHV-6 and HHV-7 DNA in clinical specimen. All type of human herpes virus DNA was detected in 12 % (18/150) cases. HHV-6 DNA was detected in 4.7% and HHV-7 DNA was detected in 2 cases (1.4%). Human herpes virus-6 and HHV-7 DNA was detected in 6% of all studied cases. HHV-6 was slightly more frequent than HHV-7. Our findings were lower than the rate of other references but were higher than the findings of previous study in Iran. This variation might be due to differences in methods, age of study cases or epidemiologic and geographic variation

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Comparison of early complications of episiotomy repair with rapid vicryl and chromic catgut in the nulliparous women

Introduction: Episiotomy has some complications such as inflammation, edema, dehiscence and perineal pain. The object of this study was comparison of the early complications of episiotomy repair with rapid vicryl and chromic catgut in the nulliparous women. Methods: In this randomized clinical trial, 100 nulliparous women during labor were randomly selected and divided equally into two groups (50 in each group). Repair of episiotomy in the first group with rapid vicryl and in the second group with chromic catgut was done. The tools were questionnaires on demographic and midwifery characteristics, Reeda scale and visual analog scale. The participants were evaluated in 4 visits: 24 hours, 3-5 days, 2 weeks and 6 weeks after delivery, respectively. In each visit, the severity of pain, redness, edema, ecchymosis, discharge and proximity to the edges of the episiotomy wound and pain intensity score were assessed. The data were analyzed using SPSS software (v. 16). Results: Mean pain intensity scores in two groups showed no significant differences. But for Episiotomy wound healing at intervals of 24 hours, 3-5 days and two weeks after delivery, but the total score of Reeda scale in rapid vicryl group was lower than chromic catgut group and this difference was statistically significant (p<0.001). Conclusion: Based on these findings, it seems that the use of synthetic sutures such as rapid vicryl is more effective than conventional natural sutures in episiotomy repai

Lavender Oil Aromatherapy on Infantile Colic and Maternal Mood: A Double Blind Randomized Clinical Trial

Background: Excessive crying is a self-limiting problem and disappears in a few weeks, however, it can be irritating for the parents, leading to maternal depression or exhaustion, and stress in the parents. The study evaluated the effect of lavender oil inhalation on duration of daily crying in the infants who suffered infantile colic. Methods: In this double blind randomized clinical trial, the main inclusion criteria were: healthy infants, no consumption of any drugs for infantile colic, healthy mothers, having one crying episode ≥ 2 hours per day (prolonged crying). The intervention group received inhalation of lavender oil and the control group received sweet almond oil for seven days. Duration of crying in the four parts of a day (morning, afternoon, evening, and night) was gathered by phone call. Also, maternal mood score was assessed at baseline and 7th day of intervention by the Edinburgh Postnatal Depression scale. Results: At baseline, the two groups were not different in relation to infant’s crying duration. However, they were significantly different after intervention in all seven days of the study (p<0.001). Also, using repeated measures analysis, the difference between the two groups was significant (p<0.001). After intervention, there was fewer prolonged crying in the lavender group compared to the control group. In lavender group, maternal mood score was significantly lower than the control group on the 7th day of intervention (p<0.001). Conclusion: The results suggest that a 1% concentration of the lavender oil can alleviate the colic symptoms and results in maternal mood improvement

Effect of lavender oil aroma in the early hours of postpartum period on maternal pains, fatigue, and mood: A randomized clinical trial

Background: Busy care providers focus on the serious complications of postpartum period. This issue causes the seemingly trivial complications, such as mother's pains, fatigue, and psychological status, to be less taken into account. The study aimed to determine the effect of lavender oil aroma in the early hours of postpartum period on maternal pains, fatigue, and mood in primiparous mothers. Methods: This randomized clinical trial was conducted on 56 participants; 29 in intervention group and 27 in control group. The intervention group received lavender oil in three doses during the first 24 h after delivery. Sesame oil was used in the control group. Intensity of pain, fatigue, and distress level was measured by visual analog scale before and after the interventions. Besides, mood status was assessed through the positive and negative affect schedule. Results: The mean age of all the participants was 23.88 ± 3.88 years. After the first intervention and also in the tomorrow morning assessment, significant differences were found between the two groups regarding perineal pain (P = 0.004, P< 0.001), physical pain (P < 0.001), fatigue (P = 0.02, P< 0.001), and distress scores (P < 0.001). In addition, significant differences were found concerning the mean scores of positive (P < 0.001) and negative (P = 0.007, P< 0.001) moods between the two groups after the interventions. Repeated measures analyses showed that the two groups were significantly different over time in all the evaluated variables. Conclusions: Lavender oil aromatherapy starting in the first hours of postpartum period resulted in better physical and mood status compared to nonaromatic group