Afsaneh Bakhtiari

Maternal expectations and experiences of labor analgesia with nitrous oxide.

Background Although there are various methods for painless delivery such as using entonox gas, most of the people are unfamiliar or concerned about it yet. Objectives The purpose of this study was to assess maternal expectations and experience of labor analgesia with nitrous oxide. Patients and Methods In a clinical trial study, 98 pregnant women in active phase of delivery were studied randomly in two groups (intervention group = 49, control group = 49) after obtaining written consent. Efficacy, experience satisfaction, and also expectation of pregnant women about entonox gas in two groups were compared, likewise in intervention group before and after using entonox gas. Results Most of the pregnant women receiving entonox gas had less labor pain (91.8%), and were satisfied with it (98%). The severity of pain in the most of entonox user was moderate level (46.94%), while for the control group it was severe (55.10%) which was significant, 40.82% of the mother in entonox group had a severe pain and 10.20% had a very severe pain, whereas in the control group (55.10%) of the mother had a severe pain and 26.53% of the had very severe pain (P = 0.004). efficacy of labor pain was in moderate level in most cases. 49% of pregnant women receiving gas described their experience as a good and excellent. 80.9% indicated that they will request the mentioned painless method in the future. The amount of suffering from gas side effects was mild in most patients of intervention group (63%). Expectations of the majority of pregnant women in intervention group (before receiving gas) and control group for painless delivery were weak (65.3%, 40.9%). The percentage of positive expectations had increased after receiving entonox gas (P = 0.01). There was a difference between the expectations of intervention group receiving entonox gas and control group (P = 0.001). Positive expectations were more in intervention group than the control group. Most differences of expectations in intervention group before and after receiving the gas were about higher efficacy (P = 0.001), more satisfaction (P = 0.001), fewer complications (P = 0.001), information about gas as painless delivery method (P = 0.02), and also previous experience of intolerable labor pain (P = 0.04). Conclusions This study has shown that using entonox gas caused less labor pain, favorable expectations and experiences and also more maternal satisfaction.

Health-Promoting Behaviors and Their Predictors in Iranian Women of Reproductive Age: A Cross-Sectional Study:

Health-promoting behaviors are one of the main determinative components of health in the prevention of many diseases. This cross-sectional study aimed to determine health-promoting behaviors and their relationship to sociodemographic variables on 330 women of reproductive age admitted to the selected primary health-care centers in Qom city (one of the biggest cities in Iran) from March 2016 to July 2016. Data were collected using the health-promoting lifestyle profile II (HPLP-II) questionnaire and the sociodemographic characteristics and also were analyzed by one-way analysis of variance, with post hoc (if necessary), and multivariable linear regression. The total HPLP-II mean score of women was 136.64 ± 22.37. The highest score in the HPLP-II subscales of women was found for interpersonal relations subscale (26.43 ± 4.21) and the lowest score for physical activity subscale (14.66 ± 4.62). The educational level and income had significant association with some subscales (p < .05).

The Association Between Physical Activity During Pregnancy and Gestational Diabetes Mellitus: A Case-Control Study

Background Gestational diabetes mellitus is one of the most common complications of pregnancy. Physical activity is associated with a lower risk of type 2 diabetes mellitus. A recent meta-analysis study suggested that more research is needed to investigate the type, duration and intensity of physical activity that can help to reduce the risk of gestational diabetes mellitus. Objectives The present study aimed to understand the association between physical activity and gestational diabetes mellitus through comparing the type and intensity of physical activity performed by pregnant females with gestational diabetes and healthy pregnant females in the first 20 weeks of their pregnancy. Patients and Methods In the current case-control study, 100 pregnant females with gestational diabetes mellitus as the case group and 100 pregnant females as the non-diabetic control group were recruited. The age range of the participants was 18 - 40 years with the gestation of 20 - 28 weeks. To diagnose gestational diabetes mellitus using the criteria introduced by carpenter and coustan females with abnormal glucose challenge test (> 140 mg/dL) were asked to perform the three-hour 100 g oral glucose tolerance test. The details of physical activity were collected by a modified version of the pregnancy physical activity questionnaire. Anthropometric and relevant data were recorded for all of the participants. Data were analyzed by SPSS version 21. Risk estimates were obtained by logistic regression and adjusted for confounders. Results Females who had low total physical activity according to the pregnancy physical activity questionnaire during early pregnancy were at a significantly higher risk of developing gestational diabetes mellitus (OR = 4.12, 95% CI (2.28 - 7.43), P = 0.001) compared to the ones who reported higher levels of physical activity. Moreover, after adjusting for age, body mass index (BMI), gravidity and a family history of diabetes, females with low physical activity in the domain of transportation activity during 20 weeks of pregnancy were at a significantly higher risk of developing gestational diabetes mellitus. The statistical findings indicate that females with the low intensity of sedentary, light and moderate physical activity are at a higher risk of developing gestational diabetes mellitus (OR 2.32; 95% CI 1.21-4.43, P = 0.010, OR 6.26; 95% CI 2.95 - 13.30, P = 0.001 and OR 6.73; 95% CI 3.15 - 14.38, P = 0.001) compared to females with a higher intensity of sedentary, light and moderate physical activity. Conclusions The amount and intensity of physical activity during pregnancy is associated with a lower risk of gestational diabetes mellitus. As a result, the pregnant Iranian females have to be encouraged to do regular daily physical activity during pregnancy, if there is no specific contraindication to it.

Metabolic syndrome and different obesity phenotypes in the elderly women population: Iran’s Health System on aging

Background: Current literature has been focused on types of obesity with normal BMI (body mass index), but metabolically unhealthy.This study evaluates the prevalence of metabolical phenotypes of obesity. We also identified the best obesity index in predicting the components of metabolic syndrome (MetS). Methods: A cross-sectional study has been conducted on 164 women over 60 years. Anthropometric parameters, body fat percentage (%BF), and biologic criteria were measured to assess the types of obesity. Unhealthy metabolic was defined by modified Adult Treatment Panel III, and obesity based on BMI≥25.ANOVA and logistic regression were utilized for the association of MetS components and obesity phenotypes, and linear regression logistic for finding the best MetS related obesity index. Results: The prevalence of metabolically unhealthy was 45.7%, out of which 33.3% was among the individuals with normal BMI.Logistic regression has shown that triglyceride (TG) (OR=3.30, p<0.001) and high density lipoprotein (HDL-C) (OR=2.15,p<0.01) was independently related to metabolically healthy and normal weight(MHNW) phenotype. Moreover, TG (OR=3.92,p<0.001), HDL-C (OR=2.18,p<0.001), fasting blood glucose(FBG) (OR=1.73,p<0.01) and waist circumference(WC) (OR=3.18,p<0.001) are correlated significantly with metabolically unhealthy and overweight/obese (MUO) and also TG (OR=2.88,p<0.001) and WC (OR=2.67,p<0.001) with metabolically unhealthy and overweight/obese(MHO).WC followed by %body fat (BF) showed to be highly correlated with the prognosis of MetS components. Conclusions: There is a high prevalence of unhealthy metabolic among the elderly women,even with normal weight.There were different associations between MetS components and various obesity phenotypes.TG was the most powerful indicator for the prognosis of unhealthy metabolic phenotypes which was independently correlated with the WC, %BF and BMI.

Risk Factors for Gestational Diabetes Mellitus: A Case-Control Study

Background: The underlying causes of gestational diabetes mellitus (GDM) are important because they are effective for the diagnosis and prevention of this condition. The aim of this study was to id...

Does the low-density lipoprotein cholesterol play a key role in predicting metabolic syndrome in the Iranian adult population?

Background: The low density lipoprotein cholestrol (LDL-C) has an important role in the pathogenesis of cardiovascular disease but its association and predictive accuracy with metabolic syndrome (MetS) remains controversial. The objective of this study was to investigate the association and predictive ability of LDL-C with MetS. Methods: We analyzed the data from a population-based cross-sectional study conducted on representative samples of an Iranian adult population. The demographic data, anthropometric measures and the lipid profiles were measured with standard methods, and MetS was diagnosed by ATP III criteria. Logistic regression model and ROC analysis were used to estimate the predictive accuracy of LDL-C and its association with MetS. Results: The mean age (±SD) of participants with and without MetS was 47.6±12.5 years and 39.1±12.9 years, respectively (p=0.001). All anthropometric measures (body mass index, waist circumference, waist to hip ratio, waist to height ratio), systolic blood pressure, total cholesterol, triglycerides and fasting blood glucose were significantly higher in MetS, but a significantly higher difference in LDL-C was observed only in women. Accuracy of LDL-C in predicting MetS for men and women was 0.48 (95% CI: 0.43-0.54) and 0.55 (95% CI: 0.51-0.60), respectively. The unadjusted and adjusted odds ratios of different quartiles of LDL-C compared with 1st quartile did not reach to a significant level. Conclusion: Serum LDL-C level is not significantly associated with MetS but exhibits a weak ability in predicting MetS in women.

Perceived health discomfort among adolescent girls and related factors in an urban area, South India

INTRODUCTION: Adolescence is a period of life that is a bridge between childhood and adulthood. India has the worlds largest adolescent girls population, and adolescent girls are an important vulnerable group of population. Perceived health is a predictor of morbidity and mortality in adults and has been an important marker of the health status in population health studies for decades. The aim of the study was to describe adolescents perception of health and association between some factors such as nutrition status, socioeconomic status (SES), and health status. As their perception of health discomfort affects their health behavior and self-care, therefore, their health status is an important matter to discuss. MATERIALS AND METHODS: A cross-sectional study was conducted in urban areas from a major city in South India. Six hundred and fifty adolescent female students aged 10–19 years formed the study population. Standardized self-reporting questionnaires were used to obtain relevant data regarding demographic features, SES, and health status. BMI calculated for each individual. The data were analyzed using SPSS version 16. RESULTS: About 83.3% of participants ranked their health status as good to excellent. A majority of the girls had one or more problems related to their menstrual cycles. The most common occurring problem was headache (45.3%). 47.8% of participants exhibited symptoms of mild insomnia. Strong significant association between nutritional status and SES was found. Higher percentage of undernourished adolescents belonged to low SES. CONCLUSION: Adolescents are expected to enjoy good health, but this does not seem to be the case in the developing countries like India, where poverty, malnutrition, and repeated infection are rampant. Majority of the problems such as healthy nutrition and self-care can be solved by community-based programs, health education, and food fortification.

Association of lipid peroxidation and antioxidant status with metabolic syndrome in Iranian healthy elderly women

The interconnection between aging and metabolic syndrome (MetS) and their effect on oxidative stress (OxS) status lacks adequate information. Additionally, the age-related changes of antioxidant defenses and OxS in senior women with MetS in comparison to healthy senior women are not yet established. We analyzed the correlation between oxidative defense status and OxS with MetS components. Through further examination of MetS and aging, we aimed to determine their independent effects on OxS and oxidative defense status. This community-based cross-sectional study was conducted in the rural area of Babol, Iran. A total of 75 women of ≥60 years of age with MetS along with 89 women with similar conditions without the MetS, serving as the control group, were studied. Blood glucose, lipid profile, malondialdehyde (MDA) and total antioxidant capacity (TAC) were determined. Data were analyzed using multiple linear regression, ANOVA and independent t-tests. MDA and TAC levels independently showed a significant correlation with triglyceride (TG), waist circumference, fasting blood glucose and high-density lipoprotein cholesterol (HDL-C). As suggested by the standardized B (0.810, -0.783, P<0.001; -0.052, P<0.001, 0.047, P<0.01), TG followed by HDL-C were the most strongly correlated factors with MDA and TAC. Furthermore, MetS and age were independent risk factors for antioxidant activity reduction and OxS. However, MetS had a much higher predictive power than age (standardized B 0.573 for MetS and 0.376 for age, P<0.001). Aging and MetS, both lead to OxS, but the impact of MetS on this disorder was far greater than the effect of age. However, their cumulative effects can lead to a worsening of the situation. Therefore, early diagnosis and treatment of MetS, especially in the elderly can prevent any adverse impact of MetS.

Female sexual outcomes in primiparous women after vaginal delivery and cesarean section

Background Sexual function is an essential component of life and yet very little is known about the relationships between the female sexuality and the mode of delivery. Objective To compare sexual outcomes after vaginal delivery and cesarean section. Methods A cross-sectional study was conducted on women in two stages; early pregnancy and 3 to 6 months after delivery in health centers. Female sexual outcomes evaluated were female Sexual Function Index scores and the time required to resume sexual activities after delivery. Results Sexual function did not differ significantly among two groups vaginal delivery n=90 and cesarean section n = 113 with regard to duration of marriage, educational level, contraception methods, and occupational status p = 0.8.The mean timing of the resumption of sexual activity was 8.9 ± 1.3, and there was no substantial conflict between the two groups. Mean frequency of intercourse in the post-partum period was 1.8±1.2 times per week with significant difference compared to pre pregnancy P<0.05. The individual domain scores after the delivery was significantly lower in comparison with pre-pregnancy p<0.004. Conclusion No differences in sexual outcomes between vaginal delivery and cesarean section. Consequently cesarean section cannot be recommended in the view of maintenance of normal sexuality after child birth.