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

Withdrawal users' experiences of and attitudes to contraceptive methods: a study from Eastern district of Tehran, Iran

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to explore withdrawal users' experiences of and attitudes to contraceptive methods in Tehran, Iran.</p> <p>Methods</p> <p>This was a cross-sectional study. A sample of women attending a health care center in Tehran, Iran was entered into the study. To collect data structured interviews were conducted.</p> <p>Results</p> <p>In all 300 women who were using withdrawal took part in the study. Of these, 210 women (70%) indicated that they were used modern contraceptive methods previously. The mean duration for withdrawal use was 6.5 (SD = 4.9) and for modern contraceptive it was 2.3 (SD = 2.9) years. The most common reasons for using withdrawal were: no cost involvement, did not need medical advice, having fewer side effects and easier to use than other methods. The main obstacles to use modern contraceptives were: health concerns, fear of side effects, misinformation, lack of confidence and sexual dissatisfaction.</p> <p>Conclusion</p> <p>The study results suggest that withdrawal users carry misconceptions about modern contraception and exaggerate its related health problems. Indeed these are important issues for the understanding of attitudes and experiences of women in Iran. The findings from this study might be essential for making evidence-based policy decisions, and for planning, monitoring and evaluating reproductive health programs in Iran and elsewhere.</p

Comparison of Sexual Function and Serum Testosterone Levels in Men Opiate Addicts, under Methadone Maintenance Therapy, and Healthy Men

Background: Substance abuse and consequently the use of methadone in Iran are reported at high levels. Drugs alter sexual function by affecting the organs of the body. The aim of this study was to evaluate sexual functioning and serum testosterone levels in opiate addicts, individuals receiving methadone maintenance treatment (MMT), and healthy men living in the city of Rafsanjan, Iran, in 2016.Methods: The statistical population of this descriptive study included: A) opium-smoking men, B) individuals undergoing MMT, and C) those without any history of substance abuse. Using a formula, the sample size consisted of 70 individuals who were randomly selected from the statistical population. The study samples also completed the International Index of Erectile Function (IIEF). Moreover, the serum testosterone levels were measured using the laboratory-based Enzyme Linked Immunosorbent Assay (ELISA) diagnostic kits. The data were analyzed by SPSS software using Mann-Whitney U and Kruskal-Wallis tests with a significant level of < 0.050.Findings: The serum testosterone levels in healthy individuals were higher than those in other two groups (P = 0.001). In addition, the sexual functioning indicators of men receiving MMT and opiate-smoking ones (P = 0.001) were lower than those of healthy individuals except for overall sexual satisfaction (P = 0.069).Conclusion: Methadone and opium reduce different aspects of sexual functioning. It seems that this change was through having impacts on serum testosterone levels; however, psychological, social, and economic dimensions are suggested to be considered in this domain

Salient Beliefs Relevant to Oral Contraceptives Among Withdrawal Users for Development of A Belief-Based Questionnaire: Applying the Theory of Planned Behavior

Introduction: The aim of this study was to elicit the salient beliefs relevant to OCs among withdrawal user for development of a belief- based questionnaire. Method: This was a qualitative study. A sample of women attending a health care center in Tehran, Iran was entered into the study. Face-to face interviews were conducted to collect data. Content analysis was performed to analyze the data. Results: In this study determined TPB constructs including indirect attitude (behavioral beliefs, outcome evaluations), indirect subjective norms (normative beliefs, motivation to comply), indirect perceived behavior control and behavioral intention. The attitude scale had 10 items five items on beliefs about the outcome of using OCs and 5 items on evaluation of a given belief. The subjective norms scale included 10 items 5 items on beliefs about the expectation of significant others and 5 items that measured motivation to comply with significant others’ expectations. The perceived behavioral control scale was comprised of 4 items. The present study measured this variable with two items. Conclusion: In this elicitation study we found that belief about Oral contraceptives. It seems that health providers should address beliefs that exist about OC and highlight the noncontraceptive health benefits of OC to balance the information provided for women. Keywords: Theory of Planned Behavior, Oral contraceptives, Withdrawal contraception, Qualitative stud

Impact of psychological problems in chemical warfare survivors with severe ophthalmologic complication, a cross sectional study

<p>Abstract</p> <p>Background</p> <p>Sulfur mustard (SM) has been used as a chemical warfare agent since the early twentieth century. Despite the large number of studies that have investigated SM induced ocular injuries, few of those studies have also focused on the psychological health status of victims. This study has evaluated the most prominent influences on the psychological health status of patients with severe SM induced ocular injuries.</p> <p>Methods</p> <p>This descriptive study was conducted on 149 Iranian war veterans with severe SM induced eye injuries. The psychological health status of all patients was assessed using the Iranian standardized Symptom Check List 90-Revised (SCL90-R) questionnaire. The results of patients' Global Severity Index (GSI) were compared with the optimal cut-off point of 0.4 that has previously been calculated for GSI in Iranian community. The Mann-Whitney U test, T tests and effect sizes (using Cohen's d) were employed as statistical methods. Data were analyzed using SPSS software.</p> <p>Results</p> <p>The mean age of patients was 44.86 (SD = 8.7) and mean duration of disease was 21.58 (SD = 1.20) years. Rate of exposure was once in 99 (66.4%) cases. The mean GSI (1.46) of the study group was higher compared to standardized cut off point (0.4) of the Iranian community. The results of this study showed that the mean of total GSI score was higher in participants with lower educational levels (effect size = 0.507), unemployment (effect size = 0.464) and having more than 3 children (effect size = 0.62). Among the participants, 87 (58.4%) cases had a positive psychological history for hospitalization or receiving outpatient cares previously and 62 (41.6%) cases had a negative psychological history. In addition, the mean of GSI in participants with negative psychological history was lower than those with positive psychological history (Mean Change Difference = -0.621 with SD = 0.120). There was a significant difference between positive and negative psychological history with respect to GSI (P < 0.001).</p> <p>Conclusion</p> <p>The study showed that severe ophthalmologic complications in chemical survivors are accompanied with destructive effects on psychological health status. Appropriate management may improve psychological health status in these patients.</p

Impact of psychological problems in chemical warfare survivors with severe ophthalmologic complication, a cross sectional study

Abstract Background: Sulfur mustard (SM) has been used as a chemical warfare agent since the early twentieth century. Despite the large number of studies that have investigated SM induced ocular injuries, few of those studies have also focused on the psychological health status of victims. This study has evaluated the most prominent influences on the psychological health status of patients with severe SM induced ocular injuries. Methods: This descriptive study was conducted on 149 Iranian war veterans with severe SM induced eye injuries. The psychological health status of all patients was assessed using the Iranian standardized Symptom Check List 90-Revised (SCL90-R) questionnaire. The results of patients&apos; Global Severity Index (GSI) were compared with the optimal cut-off point of 0.4 that has previously been calculated for GSI in Iranian community. The Mann-Whitney U test, T tests and effect sizes (using Cohen&apos;s d) were employed as statistical methods. Data were analyzed using SPSS software. Results: The mean age of patients was 44.86 (SD = 8.7) and mean duration of disease was 21.58 (SD = 1.20) years. Rate of exposure was once in 99 (66.4%) cases. The mean GSI (1.46) of the study group was higher compared to standardized cut off point (0.4) of the Iranian community. The results of this study showed that the mean of total GSI score was higher in participants with lower educational levels (effect size = 0.507), unemployment (effect size = 0.464) and having more than 3 children (effect size = 0.62). Among the participants, 87 (58.4%) cases had a positive psychological history for hospitalization or receiving outpatient cares previously and 62 (41.6%) cases had a negative psychological history. In addition, the mean of GSI in participants with negative psychological history was lower than those with positive psychological history (Mean Change Difference = -0.621 with SD = 0.120). There was a significant difference between positive and negative psychological history with respect to GSI (P &lt; 0.001)

Why Iranian married women use withdrawal instead of oral contraceptives? A qualitative study from Iran

<p>Abstract</p> <p>Background</p> <p>Withdrawal as a method of birth control is still used in Iran. The aim of this study was to explore married women's perspectives and attitudes on withdrawal use instead of oral contraceptive (OC) in Tehran, Iran.</p> <p>Methods</p> <p>This was a qualitative study. Participants were 50 married women, not currently pregnant, not desiring pregnancy and who had been using withdrawal for contraception. Face-to face interviews were conducted to collect data. Content analysis was performed to analyze the data.</p> <p>Results</p> <p>Four major themes were extracted from the interviews: advantages, disadvantages, barriers for OC use, and husband-related factors. Advantages of withdrawal use were identified as: easy to use, convenient, ease of access, natural. Even those participants who had experienced unwanted pregnancy while using withdrawal, relied on withdrawal as their contraceptive method. Disadvantages of OC included concerns about side effects. Barriers related to use of OC included the need for medical advice, vaginal examination and daily use. Husband-related factors included: the husband wanted to be the primary decision maker on the number of children and that he preferred withdrawal.</p> <p>Conclusion</p> <p>Health providers should address misunderstandings that exist about OC and highlight the non-contraceptive health benefits of OC to balance the information provided for women. We suggest that not only women but also their spouses be advised in family planning programs.</p

Effects of Adding Segmental Traction Therapy to Routine Physiotherapy on Pain and Functional Ability of Patients with Acute Low Back Pain

Background: Low back pain (LBP) is one of the most common musculoskeletal complications of today’s societies which, poses a big portion of health expenses and work absentees. Lumbar disc herniation is claimed to be one of the several causes of LBP. Conservative therapies like physiotherapy are found to be beneficial for treatment in such a kind of LBP. However, there is low evidence proving traction therapy can be effective. Therefore, the aim of this study was to evaluate effects of a 7-day physiotherapy protocol along with segmental traction therapy on pain and range of motion in patients with acute LBP Methods: A total of 9 patients with acute LBP voluntarily participated in this study. They undertook a 7-day conventional physiotherapy along with segmental traction therapy. Pain, functional ability and lumbar flexion range of motion (ROM) were measured before and after the therapeutic intervention. Results: A significant reduction in pain was observed after the intervention (P=0.006). In addition, patients’ functional ability increased significantly (P=0.03).However, there were no significant changes in lumbar in flexion ROM. Conclusion: According to results of the present study segmental traction therapy along with a physiotherapy protocol consisting of TENS, Ultrasound and Hot pack reduces pain and improves functional ability in patient with acute LBP. Although no effect on lumbar ROM is expected