Prevalence and risk factors of childbirth-related post-traumatic stress symptoms.

BACKGROUND: There 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. METHODS: This 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. RESULTS: In 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. CONCLUSIONS: The 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

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Design of Low-Power CMOS OTA Using Bulk-Drive Technique

This paper presents the design of low power CMOS- OTA (operational transconductance amplifier) using bulk drive (BD) technique with broad band. This technique is used for design of low power circuits with broad band for high frequency users, for example communication systems, mobile communication and communication forming of medical electronics. OTA is the base of amplifier .It is a fundamental building part of analog systems. Recently analog designer has been paid to low voltage (LV),low power (LP) integrated circuits. Many techniques are used for the design of LV LP circuits, the bulk driven offers principle this designs. This paper suggests a bulk driven OTA in standard CMOS processes and supply voltage 0.8 volt DC. It used of improved wilson current mirror. The simulation results have been carried out by the HSPICE simulator in 180 nm CMOS technology. The open loop gain is enhanced to 17.4dB at unity gain band with (UGB) of 26.1 MHZ with sufficient output swing. Power consumption of the OTA is in range of few hundreds of nanowatts (6%)

Prevalence and risk factors of childbirth-related post-traumatic stress symptoms

Abstract Background There 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. Methods This 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. Results In 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. Conclusions The 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.</p

Effect of Foot Massage on Pre- and Post Hysterectomy Anxiety

Background & Aim: Hysterectomy is a common gynecologic surgery leading to great concerns in women. This study aimed to determine the effect of foot massage on anxiety level after hysterectomy.   Methods & Materials: In this double-group randomized clinical trial, 60 women undergone hysterectomy were selected using convenience sampling method and were randomly allocated into two intervention or control groups. Patients in the intervention group received foot massage three sessions during three consecutive days (every session lasted 20 minutes). In the control group, the researcher was only beside the women for 20 minutes. The Spilberger anxiety questionnaire was used to measure the anxiety level. Data were analyzed using repeated measures ANOVA and independent t-test.   Results: The mean of the anxiety score was not significantly different between the two groups before the intervention (P=0.21). After the intervention, there was significant difference between the two groups in the anxiety scores (P<0.001). There was also significant difference between the two groups in the anxiety scores one week after the surgery (P<0.001).   Conclusion: Foot massage can reduce anxiety in patients who underwent hysterectomy

A New PUF-Based Protocol for Mutual Authentication and Key Agreement Between Three Layers of Entities in Cloud-Based IoMT Networks

The Internet of Medical Things (IoMT) is a promising framework for expanding and improving telemedicine services. A common cloud-based IoMT architecture consists of three layers of entities, the first layer (such as smart sensors and devices), the second layer (such as gateways), and the third layer (such as cloud servers). Obviously, in these networks, the protection of sensitive information against security threats as well as authentication between the entities is a key issue. On the other hand, the devices involved in the first and second layers usually suffer from poor computational capabilities as well as a lack of physical protection, which should be considered in the design of security protocols. Recently, Alladi et al. have proposed a lightweight authentication protocol for the cloud-based IoMT that addresses these challenges, using Physically Unclonable Function (PUF). In this paper, we first provide thorough cryptanalysis of their scheme and clarify its important vulnerabilities that lead to protocol collapse. Then, we propose a new lightweight protocol based on PUF to perform strong mutual authentication and key agreement between parties in the IoMT networks. The formal (using BAN logic) and informal security analysis demonstrate that our scheme is resistant to several well-known attacks, including physical attacks. Also, our evaluation of computational cost and security features clearly shows that the proposed scheme outperforms similar schemes in security and efficiency. Another important advantage of our protocol is that it performs the mutual authentication and key agreement process separately for each pair of layers in the three-layer cloud-based IoMT architecture. This triple authentication scheme provides the necessary flexibility for use in different scenarios and working conditions. In this aspect, as far as we know, our proposed protocol is the first of its kind

Treatment of vitamin D deficiency is an effective method in the elimination of asymptomatic bacterial vaginosis: A placebo-controlled randomized clinical trial

Background & objectives: Bacterial vaginosis (BV) is the most prevalent vaginal infection in women of reproductive age group which has been found to be associated with vitamin D deficiency. The purpose of this study was to investigate the effectiveness of the administration of 2000 IU/day edible vitamin D for 15 wk to eliminate asymptomatic BV among reproductive age women with vitamin D deficiency. Methods: A total of 208 women with asymptomatic BV, who were found to be eligible after interviews and laboratory tests, were randomly assigned to a control group (n=106) or an intervention group (n=105). They used vitamin D drops daily for 105 days. Vaginal and blood samples were taken before and after the second intervention using identical methods (Nugent score for BV diagnosis, serum 25-hydroxyvitamin D for vitamin D determination). Results: The cure rate of asymptomatic BV was 63.5 per cent in the intervention and 19.2 per cent in the control group (P <0.001). The results showed that being unmarried (P=0.02), being passive smoker (P<0.001), and being in the luteal phase of a menstrual cycle during sampling (P=0.01) were significantly associated with post-intervention BV positive results. After these elements were controlled, the odds of BV positive results in the control group was 10.8 times more than in the intervention group (P<0.001). Interpretation & conclusions: Among women in reproductive age group with vitamin D deficiency, the administration of 2000 IU/day edible vitamin D was effective in eliminating asymptomatic BV. This treatment could be useful in preventing the symptoms and side effects of BV

Pregnancy rate, maternal and neonatal outcomes among breast cancer survivors: A systematic review

Abstract Aim This study investigated the pregnancy rate, maternal and neonatal outcomes, and breast cancer (BC) recurrence status after pregnancy among BC survivors. Design A systematic review. Methods Electronic databases such as PubMed, Web of Science [WOS], Scopus, ScienceDirect, Google Scholar, and Scientific Information Database were systematically searched. The quality of included studies was evaluated using the Newcastle–Ottawa Scale (NOS). Observational studies reported the pregnancy rate, maternal and neonatal outcomes among reproductive‐aged BC survivors, and the recurrence status of BC after pregnancy were eligible to include in this study. Results Of the 29 included studies, 13 studies were prospective cohorts or prospective multicenter or population‐based cohorts, 14 studies were retrospective cohort or retrospective population‐based cohort studies, and two studies were cross‐sectional retrospective surveys or population‐based descriptive studies. This systematic review showed that the pregnancy rate was estimated at 3.1%–48.5% among BC survivors who attempted to conceive. The most prevalent maternal outcomes of pregnancy were miscarriage (1.8%–33.3%) and induced abortion (5.0%–44%) as well as preterm birth (PTB) or very PTB (1.2%–21.1%), and twin birth (1.1%–38.8%) were the most prevalent neonatal outcomes occurring among BC survivors, respectively. In addition, most of the included studies indicated that pregnancy had no adverse effect on the status of BC recurrence among survivors. Surviving women can be encouraged and receive a carefully multidisciplinary approach regarding healthy pregnancy. No Patient or Public Contribution

Reproductive health issues in female patients with beta-thalassaemia major: a narrative literature review

β-thalassaemia major (BTM) has a high prevalence worldwide and is associated with considerable morbidity and mortality. The aim of this review is to provide an illustrative overview of the reproductive health and pregnancy related issues in females with β-thalassaemia. A literature search was performed in four international databases (1980–2018) to identify the potentially relevant articles. Common reproductive health disorders are hypo-gonadotrophic hypogonadism, infertility, delayed or absent sexual development, diabetes, hypothyroidism, hypoparathyroidism, osteopenia, preeclampsia, gestational hypertension, polyhydramnios, oligohydramnios, thrombosis, renal failure, peripheral vascular resistance, placenta previa, pleural effusion and pulmonary hypertension. Many of those aspects are related to iron overload and to ineffective erythropoiesis. Foetal complications include neural tube defects, abnormalities in different organs, spontaneous abortion, foetal loss, preterm birth, foetal growth restriction and low birth weight. Antenatal screening and accurate genetic prenatal examinations are effective measures to early diagnosis of thalassaemia and a detailed plan for management of pregnancies in BTM is important for favourable maternal and foetal outcome