Effect of peppermint water on prevention of nipple cracks in lactating primiparous women: a randomized controlled trial

BACKGROUND: Nipple pain and damage in breastfeeding mothers are common causes of premature breastfeeding cessation. Peppermint water is popularly used for the prevention of nipple cracks in the North West of Iran. The aim of this study was to determine the effectiveness of peppermint water in the prevention of nipple cracks during breastfeeding in comparison with the application of expressed breast milk (EBM). METHODS: One hundred and ninety-six primiparous breastfeeding women who gave birth between February and May 2005 in a teaching hospital in Tabriz, Iran, were randomized to receive either peppermint water or EBM. Each woman was followed for up to three visits or telephone calls within 14 days and then by telephone call at week six postpartum. RESULTS: Women who were randomized to receive peppermint water were less likely to experience nipple and areola cracks (9%) compared to women using EBM (27%; p < 0.01). Women who used the peppermint water on a daily basis were less likely to have a cracked nipple than women who did not use peppermint water (relative risk 3.6, 95%CI: 2.9, 4.3). Nipple pain in the peppermint water group was lower than the expressed breast milk group (OR 5.6, 95% CI: 2.2, 14.6; p < 0.005). CONCLUSION: This study suggests that peppermint water is effective in the prevention of nipple pain and damage. Further studies are needed to assess the usefulness of peppermint water in conjunction with correct breastfeeding techniques. Trial registration number: NCT0045640

The chemical composition and in vitro digestibility evaluation of almond tree (Prunus dulcis D. A. Webb syn. Prunus amygdalus; var. Shokoufeh) leaves versus hulls and green versus dry leaves as feed for ruminants

Almond, (Prunus dulcis D. A. Webb syn. Prunus amygdalus) is a species belonging to the Rosaceae family (Sfahlan et al. 2009). The state of California in the USA is the major producer of almond; however, its production is widely distributed (Wijerante et al. 2006) and there is increasing interest to produce almond and its by-products worldwide. Approximately 2,112,815 metric ton of almonds with shell is produced globally with Iran contributing about 110,000 metric ton (FAO 2007). Almond is a midsize tree with fruit that can grow up to ten meters tall (Chen et al. 2010). The fruit is made of hulls, shell and kernel. Drying almond hulls results in approximately (kg-1 DM) 250 g nut, 500 g hulls and 250 g shell (Aguilar et al. 1984; Fadel 1999).The current study aimed to evaluate the chemical composition and in vitro digestibility of almond tree (Prunus dulcis D. A. Webb syn. Prunus amygdalus; var. Shokoufeh) leaves versus hulls, and green versus dry leaves as feed for ruminants. The fresh green almond hulls (GAH) and leaves (GAL) were harvested and spread under a shade to dry. Dry almond leaves (DAL) were collected from under the trees where as dry almond hulls (DAH) were collected 4 weeks after harvesting the fresh samples. The chemical composition of substrates was determined using standard approaches and the metabolisable energy (ME), in vitro dry matter (DMD) and in vitro organic matter (OMD) digestibility were measured using the in vitro gas production (GP) technique. The GAL contained 81 g crude protein (CP) kg-1 DM while DAH contained 103 g CP kg-1 DM. The CP was higher (P = 0.0003) in dry (leaves and hulls) than in green (leaves and hulls) samples. The ash content ranged from 99.2 to 181.5 g kg-1 DM in DAH and DAL, respectively, (P = 0.0041). The ether extract content ranged from 27 for DAH to 65 g kg-1 for DAL (P = 0.0018). The acid detergent fibre and neutral detergent fibre content ranged from 185 to 304 and 444 to 620 g kg-1 DM (P = 0.04), for GAL and DAH, respectively. The DAH had the highest (P = 0.0001) GP24 and GP96. The DAH had the highest (P = 0.0001) potential GP (i.e., b), while the GP rate was highest for GAL and GAH (P = 0.034), ME was highest for DAH (P = 0.0001), and in vitro OMD was highest for DAH (P = 0.0001). The highest DMD (P = 0.0001) values were obtained with DAH followed by GAL, DAL and GAH, respectively. It can be concluded that almond hulls and leaves have a good nutritional potential to cover the maintenance nutrient requirements of small ruminants. Almond hulls and leaves can also be used as supplement to low quality mature pasture and/or crop residues. However, more studies are warranted to better characterize these feeds in in vivo animal feeding trials

Assessment of Knowledge and Performance of the Parents at the Management of Fever in Children

Background When a child’s body temperature rises, most parents become very worried that high fever may harm the child; in this study, knowledge and performance of the parents at the time of fever in children and how they act when encountering children’s fever were studied. Materials and Methods  In this cross-sectional descriptive study, samples (300 parents of children under 10 years) were selected using the convenience sampling method among the children admitted to Children's Hospital of Tabriz, Iran, and these parents completed the research made questionnaire of parental knowledge and performance at the time of fever in children. Data were analyzed using SPSS version 20.0. Results The most common complication of high fever from the parents’ views was febrile seizure in 141 cases (47%). The use of corticosteroids for the treatment of fever in this study was observed in 23 cases (7.7%), and 40.7% of mothers had received their information about fever and how to manage it in children from doctors and nurses. In this study 87 (29%) of mothers had used thermometer to check for the child’s fever. In total, 53% of mothers knew the correct definition of standard fever temperature. Results showed that 161 (53.7%) of mothers believed in feeding the child more fluids than usual, 21 (7%) believed in feeding the child less fluids than usual, and 118 (39.3%) believed in feeding the child the same amount of fluids as before. In total, 25.7% of mothers had used antibiotics to treat their child’s fever. Conclusion "Fever phobia" continues to be common among parents. Parents have low level of awareness about children’s fever. Such low awareness and parents’ wrong perception of fever and their excessive fear and anxiety cause them fail to act properly

Complications and Risk Factors of Neonatal Macrosomia: A Case-Control Study

Background: Macrosomia is defined as the birth weight of greater than or equal to 4,000 grams, which is considered to be a public health issue threatening mothers and neonates. Studies indicate that the prevalence rate of macrosomia is on the rise in developing countries. The present study aimed to evaluate the influential factors in the occurrence of neonatal macrosomia. Methods: This case-control study was conducted at Al-Zahra Hospital in Tabriz, located in the north-west of Iran, during March 2013-February 2014. Sample population included all the live-born neonates and their mothers. The case group consisted of the neonates with the birth weight of ≥4,000 grams (n=404), and the control group included 404 newborns weighing 2,500-3,999 grams. Data were collected using a maternal and neonatal information form (maternal age, neonatal gender, mode of delivery, maternal height, and maternal history of diabetes). Data were extracted from the medical files of the samples and recorded in the form. Data analysis was performed in SPSS version 20 using descriptive and inferential statistics (independent t-test and 2χ) at the significance level of α=0.05. Results: In total, 8,012 neonates were born during the study, 404 of whom has macrosomia (5.04%). Mean maternal age in the case and control groups was 29.6±6.1 and 27.9±8.3 years, respectively (

Evaluation and outcomes of pediatric pleural effusions in over 10 years in Northwest, Iran

Abstract Background: Pleural effusion is the accumulation of excess fluid in the pleural cavity. Most information available about pleural effusion is obtained from studies on adults and little evidence is available in children. Therefore, it is necessary to identify the existing status and explain the disease process, signs, treatment, and prognosis. Children with pleural effusion who were admitted to children’s university hospital during the last ten years were studied in this research. Methodology: In this descriptive research, children with pleural effusion who were admitted and undergone thoracocentesis in the children’s university hospital during the last ten years were studied. The data obtained from in vitro experiments and the information questionnaire was analyzed using SPSS-18 through descriptive statistics of frequency, percent, and mean. Findings: Ninety-four children with pleural effusion were admitted during 10 years. Pleural effusion was exudate in 56.38% and transudate in 43.61% of children. The most common symptoms were tachypnea, fever, and cough. Antibiotic administration was the most performed therapeutic action. Conclusion: The mode of addressing pleural effusion in this research was similar to other studies. Considering the results, better planning can be performed regarding preventing this disease or improving its prognosis

Evaluation and outcomes of pediatric pleural effusions in over 10 years in Northwest, Iran

Abstract Background: Pleural effusion is the accumulation of excess fluid in the pleural cavity. Most information available about pleural effusion is obtained from studies on adults and little evidence is available in children. Therefore, it is necessary to identify the existing status and explain the disease process, signs, treatment, and prognosis. Children with pleural effusion who were admitted to children’s university hospital during the last ten years were studied in this research. Methodology: In this descriptive research, children with pleural effusion who were admitted and undergone thoracocentesis in the children’s university hospital during the last ten years were studied. The data obtained from in vitro experiments and the information questionnaire was analyzed using SPSS-18 through descriptive statistics of frequency, percent, and mean. Findings: Ninety-four children with pleural effusion were admitted during 10 years. Pleural effusion was exudate in 56.38% and transudate in 43.61% of children. The most common symptoms were tachypnea, fever, and cough. Antibiotic administration was the most performed therapeutic action. Conclusion: The mode of addressing pleural effusion in this research was similar to other studies. Considering the results, better planning can be performed regarding preventing this disease or improving its prognosis

Effect of peppermint water on prevention of nipple cracks in lactating primiparous women: a randomized controlled trial

Abstract Background Nipple pain and damage in breastfeeding mothers are common causes of premature breastfeeding cessation. Peppermint water is popularly used for the prevention of nipple cracks in the North West of Iran. The aim of this study was to determine the effectiveness of peppermint water in the prevention of nipple cracks during breastfeeding in comparison with the application of expressed breast milk (EBM). Methods One hundred and ninety-six primiparous breastfeeding women who gave birth between February and May 2005 in a teaching hospital in Tabriz, Iran, were randomized to receive either peppermint water or EBM. Each woman was followed for up to three visits or telephone calls within 14 days and then by telephone call at week six postpartum. Results Women who were randomized to receive peppermint water were less likely to experience nipple and areola cracks (9%) compared to women using EBM (27%; p Conclusion This study suggests that peppermint water is effective in the prevention of nipple pain and damage. Further studies are needed to assess the usefulness of peppermint water in conjunction with correct breastfeeding techniques. Trial registration number: NCT00456404</p