Further evidence of psychological factors underlying choice of elective cesarean delivery (ECD) by primigravidae

Objective: Requests for elective cesarean delivery (ECD) have increased in Iran. While some sociodemographic and fear-related factors have been linked with this choice, psychological factors such as self-esteem, stress, and health beliefs are under-researched. Methods: A total of 342 primigravidae (mean age = 25 years) completed questionnaires covering psychological dimensions such as self-esteem, perceived stress, marital relationship quality, perceived social support, and relevant health-related beliefs. Results: Of the sample, 214 (62.6%) chose to undergo ECD rather than vaginal delivery (VD). This choice was associated with lower self-esteem, greater perceived stress, belief in higher susceptibility to problematic birth and barriers to an easy birth, along with lower perceived severity of ECD, fewer perceived benefits from VD, lower self-efficacy and a lower feeling of preparedness. No differences were found for marital relationship quality or perceived social support. Conclusions: The pattern suggests that various psychological factors such as self-esteem, self-efficacy, and perceived stress underpin the decision by primigravidae to have an ECD

Relationship between dental plaque formation and salivary cortisol level in pregnant women

Purpose: Understanding how increased level of salivary cortisol contributes to the development of dental biofilm during pregnancy can help inthe prevention of dental caries and periodontal diseases. This study aims to evaluate the relationship between salivary cortisol level and dental biofilm formation in pregnant women. Patients and methods: This descriptive-analytic study was conducted in Hamadan, Iran in 2011. Forty consecutive pregnant women with no history of abortion, stillbirth, or any known physical or psychological disorders at weeks 25 and 33 of gestation were included. Salivary samples were collected for measurement of cortisol levels by Enzyme Linked Immunoabsorbent Assay (ELISA) method. The amount and extension of dental biofilms were determined by using a disclosing agent. Data were analyzed using descriptive and analytical statistics in SPSS version 16. Results: The mean levels of salivary cortisol at weeks 25 and 33 of gestation were respectively, 2.45 +/- 1.56 mug/dl and 5.24 +/- 4.07 mug/dl which demonstrates a significant difference (P<0.001). Evaluation of dental biofilm at two time intervals revealed a significant increase in amount of dental biofilm at week 33 of gestational period (34.65 +/- 10.9 vs. 42.45 +/- 12.35, P<0.001). Elevated levels of dental biofilm were significantly correlated with salivary cortisol levels at week 33 (r=0.494, P=0.001),however, it was not significant at week 25 of gestation (r=0.148, P=0.361). Conclusion: The findings suggested that increased levels of salivary cortisol can predict dental biofilm formation and accumulation in pregnant women in the last weeks of gestation

Correlation Between Migraine Headaches and Obsessive-Compulsive Disorder: A Two Year Study

Background: Migraine is the most common cause of headache which affects 15% of female and 6% of male populations. Patients with migraine may have psychological problems, thus, association of migraine with depression, anxiety and other psychological disorders should be considered for choosing the best management approach. Methods: In this case-control analytical study, one hundred and twenty patients with migraine were recruited among patients who attended the Psychiatry Clinic of Farshchian Hospital in Hamedan, Iran during 2008- 2009. The patients met the IHS criteria for migraine and none had disorders, such as Huntington disease, that are associated with obsessive-compulsive disorder (OCD). The people who accompanied patients attending the Internal Medicine Clinic of the Hospital and had no history of migraine headaches were recruited as the controls. Maudsleys inventory was used for the diagnosis of OCD. Finally, the data were analyzed by SPSS software. Results: In the control group, 3 (2.5%) and in the case group 11 (9.17%) people had OCD (P=0.024). All of those with OCD in the control group and 9 out of 11 in the case group were female. There were no cases of OCD among patients with mild migraine. Among 36 patients with moderate headache 5 (13.89%) people had OCD and among 62 people with severe migraine 6 (9.68%) had OCD (P=0.510). Conclusion: The prevalence of OCD in patients with migraine was significantly higher than the normal population. Special attention to comorbid conditions such as OCD is necessary in the management of migraine headaches

Oxybutynin reduces sweating in depressed patients treated with sertraline: a double-blind, placebo-controlled, clinical study

Ali Ghaleiha,1 Leila Jahangard,1 Zahra Sherafat,1 Mohammad Ahmadpanah,1 Serge Brand,2 Edith Holsboer-Trachsler,2 Hafez Bajoghli,3 Mohammad Haghighi11Research Center for Behavioral Disorders and Substances Abuse, Hamadan University of Medical Sciences, Hamadan, Iran; 2Psychiatric Hospital of the University of Basel, Center for Affective, Stress and Sleep Disorders, University of Basel, Basel, Switzerland; 3Psychiatry and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, IranBackground: Selective serotonin reuptake inhibitors are primarily used in the pharmacological treatment of patients experiencing a major depressive disorder. However, one of the common unwanted effects is excessive sweating or hyperhidrosis. Oxybutynin is an anticholinergic medication which reduces sweating. The aim of this double-blind study was to examine the effect of administration of oxybutynin on subjective sweating in patients treated with sertraline.Methods: A total of 140 patients experiencing a major depressive disorder (mean age 37.69 &amp;plusmn; 10.44 years, 86 females [61.4%]) treated with sertraline (mean dose 83 mg/day) were consecutively enrolled in the study, and all reported excessive sweating as a side effect. Thereafter, the patients were randomly assigned to either an oxybutynin 5 mg/day group or to a placebo group. At the beginning and end of the 2-week trial, the patients completed questionnaires related to sweating and medication-related side effects.Results: Over time, subjective sweating reduced significantly in the treatment group as compared with the control group. Oxybutynin-induced side effects were uncommon. Relative to male patients, female patients reported less subjective sweating.Conclusion: Administration of oxybutynin successfully reduced excessive sweating in patients experiencing a major depressive disorder and treated with sertraline. However, possible gender effects should be taken into account.Keywords: oxybutynin, sweating, sertraline, major depressive disorder