A systematic review and meta-analysis of clinical trials on saffron (Crocus sativus) effectiveness and safety on erectile dysfunction and semen parameters

Objective: We performed this systematic review and meta-analysis study to determine saffron (Crocus sativus) effectiveness and safety in male infertility problems. Materials and Methods: The databases PubMed, Scopus, Cochrane, Google Scholar, SID, IranMedex and Magiran until July 2016 and reference section of relevant articles, were searched to find both English and Persian clinical trials on male infertility issues that used saffron as medical treatment. Also, the quality of these trials was evaluated by Oxford Center for Evidence Based Medicine checklist. A total of six trials was ultimately included. All statistical analyses were done by Comprehensive Meta-analysis (CMA) Version 2. Results: Only in one study conducted on sperm parameters, the mean percentage of sperm with normal morphology (

The effectiveness and safety of Iranian herbal medicines for treatment of premenstrual syndrome: A systematic review

Objective: Premenstrual syndrome (PMS) is one of the most common problems among women of reproductive age. The popularity of complementary/alternative therapies has grown in recent years, and these treatments have been more commonly used by women (48.9%) than men (37.8%). The aim of this systematic review was to assess effectiveness and safety of Iranian herbal medicines for treatment of premenstrual syndrome. Methods: PubMed, Scopus, Cochrane, and Google Scholar were searched along with SID, Magiran and Irandoc up to Dec 2017. Inclusion criteria consist of Iranian, published, randomized controlled trials (RCTs) using Iranian herbal medicine for treatment of reproductive age women with PMS. Eventually Eighteen RCTs met the inclusion criteria. Results: Overall, studies have shown that Vitex agnuscastus, Hypericum perforatum, Matricaria chamomilla, saffron, Curcumin, Melissa officinalis, Zataria multiflora,Wheat Germ Extract, Echinophora platyloba, Foeniculum vulgare, Valerian root extract, Citrus sinensis, Zingiber officinale andFlax seed might alleviate symptoms of PMS. Conclusion: This research demonstrated efficacy and safety of Iranian herbal medicines in alleviating PMS. Therefore, herbal medicine can be regarded as an alternative treatment for women suffering from PMS

The Quality of Maternity Services in Mashhad Educational Hospitals, Using SERVUSE Model

Introduction: Reducing maternal and neonatal mortality requires improved care quality; the aim of this study was to determine various dimensions of the quality of services in maternity wards in Iran from the patient’s perspective. Methods: In this cross-sectional study which was conducted from April to October 2017, 363 patients were selected from maternity wards of five hospitals affiliated to Mashhad University of Medical Sciences by convenience sampling method. Data collection tools consisted of the SERVUSE (Service Usability questionnaire), including 51 items in 6 dimensions of services quality; its validity and reliability were determined in previous studies. Data analysis was performed using SPSS, version 20. The analysis was performed using descriptive and inferential statistical methods including Wilcoxon, Kruskal Wallis and Mann-Whitney tests. The significance level in all the tests was considered 5%. Results: The total mean scores of the patients’ expectation and perception were 19.10±2.14 and 15.11±4.25, respectively. The highest expectation and perception were related to the usability dimension, and the lowest expectation and perception were related to reliability dimension. The differences between the median score of perception and expectation for all dimensions and total median score of perceptions and expectations were statistically significant (P<0.05, using Wilcoxon test). There were no statistically significant differences in the median score of the gap between the patient’s expectations and perceptions at the levels of demographic variables (P>0.05, using Mann-Whitney and Kruskal Wallis tests). Conclusion: It seems that the service quality of maternity ward of hospitals was approximately unsatisfactory from the patients’ perspective, and they had high expectations in maternity wards of hospitals. Since maternity service quality is critically important, improvement of quality requires management, concordant participation, and efforts of the hospital and staff at all levels of the medical facilities and convenience

Maternal, Fetal and Neonatal Outcomes in Pregnant Women with Systemic Lupus Erythematosus: A Comprehensive Review Study

Background:Systemic lupus erythematosus (SLE) is an autoimmune disease with multiple organ involvement and periods of relapse and remission that mainly affects young women of childbearing age. In this regard the reproductive health is an important issue. Although diagnosis, treatment and management of pregnancy in SLE women have been improved recently, but the main concern is effects of SLE on maternal, fetal and neonatal outcomes. This study aimed to investigate the maternal, fetal and neonatal outcomes in pregnant women with SLE. Materials and Methods: The databases of PubMed, Medline, Scopus and Web of Science as well as domestic database (Persian) such as SID, Magiran, Irandoc, and Google Scholar were searched with using keywords such as" Systemic lupus erythematosus"; "Pregnancy"; "Neonatal lupus"; "maternal, fetus or neonatal outcome";  and equivalent Persian words. Included were all Persian and English articles, published between 2000 and May 2017. Finally, a total of 77 studies were included. Results: Adverse perinatal outcomes increase in pregnancies with lupus. Outcomes include respiratory, cardiovascular, blood and skin disorders in mothers; stillbirth, spontaneous, and recurrent abortion in fetuses and neonatal lupus, prematurity, intrauterine growth restriction (IUGR), and small for gestational age (SGA) in neonates, respectively. Conclusion: Pregnant women with SLE are at high risk due to increased complications for both mother and fetus. It seems broad control of the women before fertilization, so that they be at full remission in the beginning of pregnancy and the disease activity be in complete control, it can help to improve outcomes of pregnancy and so better results can be expected

Effectiveness of infertility counseling on pregnancy rate in infertile patients undergoing assisted reproductive technologies: A systematic review and meta-analysis

Background: Psychological interventions such as counseling for infertile patients seem to increase pregnancy rate. Objective: The aim of this systematic review and meta-analysis was to examine if counseling improves pregnancy rate among infertile patients. Thus, randomized controlled trials investigating the effect of counseling on pregnancy rate in infertile patients undergoing ART were pooled in a meta-analysis. Materials and Methods: The databases of PubMed, Scopus, Cochrane, Google Scholar, and Persian databases including SID, Iran Medex, and Magiran were searched from 1997 to July 2016 to identify relevant articles. Included studies were trials on infertile patients (women or couples) receiving counseling independent of actual medical treatment. The outcome measure was pregnancy rate. Out of 620 relevant published trials, a total of nine RCTs were ultimately reviewed systematically and included in a meta-analysis to measure the efficacy of counseling on pregnancy rate. Odds ratio and Risk difference were calculated for pregnancy rate. All statistical analyses were done by Comprehensive Meta-analysis Version 2. Results: Nine RCTs involving 1079 infertile women/couples were included in the study. The findings from RCTs indicated significant effect of counseling on pregnancy rate so that there was a positive impact of counseling on pregnancy rate (OR= 3.852; 95% CI: 2.492-5.956; p=0.00) and (RD= 0.282; 95%; CI: 0.208-0.355; p=0.00). Conclusion: Counseling was found to improve patients&rsquo; chances of becoming pregnant. So counseling represents an attractive treatment option, in particular, for infertile patients who are not receiving medical treatment

The effect of mother-infant skin to skin contact on success and duration of first breastfeeding: A systematic review and meta-analysis

Breast-feeding initiation within the first half hour after birth is one of the World Health Organization recommendations. However, in most hospitals, mother-infant contact and breast-feeding initiation are delayed due to routine mother and infant care. This study aimed to determine the effect of mother-infant skin to skin contact (SSC) immediately after birth on the success rate and duration of the first breast-feeding.In this review, databases of PubMed, Scopus, Cochrane, Google Scholar, SID and Magiran and reference sections of relevant articles were searched for both Persian and English randomized clinical trials from 2000 to December 2017, using the keywords of “(Breast-feeding OR Lactation) AND (mother-infant SSC OR KMC) AND (breast-feeding success OR breast-feeding duration)”. A total of nine trials were ultimately included. Data analysis was performed with Comprehensive Meta-analysis (CMA) software version 2.In total 597 participants were assigned to the intervention group and 553 participants were assigned to the comparison group. Quantitative analysis Based on mean differences or odds ratio showed that Mother-Infant SSC had a significantly positive effect on success in first breast-feeding (MD:1.90, 95%; CI 0.958–2.856; p = 0.00, OR: 2.771 95%; CI 1.587–4.838; p = 0.00) and first breast-feeding duration (MD:26.627 95%; CI 1.070–52.184; p = 0.041).Mother-infant SSC after birth has beneficial effects on breast-feeding and can increase the success rate and duration of the first lactation. Therefore, the results of this study can be used by healthcare providers in evidence-based decision-making about ways to increase breast-feeding rates. Keywords: Mother-infant skin to skin contact, Breast feeding, Meta-analysis, Systematic revie

Investigating the Breastfeeding Self-Efficacy and its Related Factors in Primiparous Breastfeeding Mothers

Background: Breastfeeding is one of the most effective behaviors in health promotion and one of factor affecting its success, is breastfeeding self-efficacy. Low breastfeeding self-efficacy entails consequences such as early cessation of breastfeeding, reduction of exclusive breastfeeding, negative effect on sensation and performance. Regarding this study aimed to investigate the breastfeeding self-efficacy and its related factors in pramiparous breastfeeding mothers. Materials and Methods: This descriptive cross-sectional study was conducted on 300 primiparous breastfeeding mothers with less than 6 months infants referring to healthcare centers of Mashhad, Iran. The study population was selected through multi-stage random sampling technique. Data collection was performed by demographic form and Breastfeeding Self-efficacy Scale developed by fax and Dennis (1999). Data were analyzed using descriptive and inferential statistics, through SPSS version 16. Results: In present study,majority of participants were housewife within the age range of 15-25 years with diploma education and had normal delivery. Majority (79.33%) of mothers had high level of breastfeeding self-efficacy with a mean of 130.89±13.60. According to the multiple regression model, employed mothers (B =5.88, p=0.040) with an appropriate income (B=3.7, p=0.42) had significantly higher breastfeeding self-efficacy, compared to those with low family income. On the other hand, mothers with rental houses had significantly lower breastfeeding self-efficacy than their peers with owned properties (B = -3.48, p=0.023). Conclusion: As findings indicated, breastfeeding self-efficacy of participants was at high level. This factor can help health care providers to predict length of breastfeeding, and success rate of exclusive nutrition in mothers, and thereby identify mothers, who are at risk of early breastfeeding stop