Shiraz University of Medical SciencesWomen’s Health Bulletin2345-51364220170401The Importance of Internet-based Educational and Clinical Interventions and Social Networks in Pregnant Women124525410.17795/whb-41741ENRoxanaSharifianAssociate Professor of Health Information Management, Shiraz University of Medical Sciences, Shiraz, IR IranElhamFallahnejadStudent of Health Information Technology, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, IR IranFatemehNiknamStudent of Health Information Technology, Shiraz University of Medical Sciences, Shiraz, IR IranJournal Article19700101Nonehttps://womenshealthbulletin.sums.ac.ir/article_45254_01a2ebffdcf36b700381b9b2569ca061.pdfShiraz University of Medical SciencesWomen’s Health Bulletin2345-51364220170401A Narrative Review of Obesity and Its Associated Complications in Iranian Women194525510.17795/whb-40546ENParvinMirmiranNutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IranFaculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, IranZeinabGhorbaniNutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IranFiroozehHosseini-EsfahaniNutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IranJournal Article19700101<strong>Context:</strong> Obesity is a major public health problem worldwide. This review aimed at providing an updated overview of obesity in Iranian women and its associated complications.
<strong>Evidence Acquisition:</strong> In this narrative review study, related systematic reviews or meta-analysis studies of high ranking journals conducted from 2000 to 2016 were searched in the PubMed, Medline, and Scopus with the following keywords: “women OR female” AND “weight OR overweight OR obesity”, “risk factors OR complications”, “reproduction OR cancer OR cardiovascular disease OR diabetes OR gestational diabetes OR maternal obesity OR fertility OR pregnancy OR polycystic ovary syndrome” OR management.
<strong>Results:</strong> In Iran, women have shown a constantly higher risk of obesity compared to men. After a 9- year follow-up, the age-standardized incidence rate (95% CI) of diabetes was 10.1 (7.24 - 13.9) in women. The increases in overweight and obesity in menopausal women have an important role in endometrial, colon, and breast cancer. Obesity increases the risk of endometrial cancer 2.4 to 4.5 folds compared to the normal weight women. Maternal obesity increases the risk of gestational hypertension 4.5 to 8.7 times compared to normal weight women. An increasing number of obese women becoming pregnant is associated with short- and long-term maternal and child outcomes. The prevalence of childhood obesity in children of obese women aged 3 to 5 years increases up to 25%; and these children have an almost 6- fold chance of being obese in young adulthood. Weight reduction of obese women is accompanied with lower incidence of obesity complications. The most effective interventions are multiple behavioral management activities.
<strong>Conclusions:</strong> Considering the large population of young people in Iran and the lack of any effective preventive policy, the burden of obesity and its associated outcomes will be problematic in the near future.https://womenshealthbulletin.sums.ac.ir/article_45255_c7046e8b2b1a67255370a21c496faa0a.pdfShiraz University of Medical SciencesWomen’s Health Bulletin2345-51364220170401Awareness, Attitudes and Tendency Toward Providing Services to Patients With HIV/AIDS by Second- and Third-Year Nursing Students in Isfahan, Iran, 2014164525610.17795/whb-32339ENMaryamHasanshahiMSc Student, Department of Health Education and Promotion, School of Public Health, Isfahan University of Medical Sciences, Isfahan, IR IranAbdolvahhabBaghbanianPhD, Faculty of Health Sciences, University of Sydney, AustraliaNasrinMotazedianMD, Shiraz HIV/AIDS Research Center, Shiraz University of Medical Sciences, Shiraz, IR IranShiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran0000-0001-9534-4014Journal Article19700101<strong>Background:</strong> Nurses are one of the most significant group exposed to the risk of acquired immune deficiency syndrome (AIDS). Therefore, to determine the disease level in patients and train them in the field are among the most essential subjects of nursing education. The study investigated the nursing students’ awareness, attitudes and tendency toward providing services to patients with HIV/AIDS.
<strong>Methods:</strong> This cross-sectional study, conducted in 2014, covered 110 second- and third-year nursing students from Isfahan University of Medical Sciences, Isfahan, Iran. The research tools were demographics and AIDS knowledge questionnaires, an attitude towards AIDS scale and a discrimination against patients questionnaire. The information was analyzed by SPSS using descriptive statistics, t-test and the Pearson correlation coefficient.
<strong>Results:</strong> Males comprised 38.2% of the subjects, and females 61.8%. About 80% of the participants were single and 20% married. Almost two-thirds (60.9%) had a professional background. Regarding the awareness of AIDS and its transmission methods, 52.7% of the students were “a little” aware. Furthermore, 84.5% of students were at the moderate level of discrimination on giving services and taking care of patients with HIV; 52.2% of the subjects were also at a moderate level. A significant direct relationship was observed between the discrimination and attitude scores, P = 0.04 and r = 0.19.
<strong>Conclusions:</strong> The students’ levels of awareness of HIV and its transition methods were low, and this should be promoted thorough training. Discriminatory actions do occur, and it is necessary and possible to decrease their incidence by promoting students’ awareness of patients’ rights and ethical principles.https://womenshealthbulletin.sums.ac.ir/article_45256_01db6c55a4b810237ff683ea2c5dbbea.pdfShiraz University of Medical SciencesWomen’s Health Bulletin2345-51364220170401Factors Influencing the Desired Number of Children Among Married Women in the Reproductive Age and its Implications for Policy Making164525710.17795/whb-38928ENKhadijehAsadi SarvestaniPhD Candidate of University Sains Malaysia, MalaysiaLecturer in Department of Sociology and Social Planning, Shiraz University, Shiraz, IR IranSuetLeng KhooSenior Lecturer in Department of Development Planning and Management, University Sains Malaysia, MalaysiaNorMalina MalekAssociate Professor in Department of Development Planning and Management, University Sains Malaysia, MalaysiaSuzianaMat YasinSenior Lecturer in Department of Development Planning and Management, University Sains Malaysia, MalaysiaAliyarAhmadiAssistance Professor in Department of Sociology and Social Planning, Shiraz University, Shiraz, IR IranJournal Article19700101<strong>Background:</strong> Desired number of children is one of the main indexes showing the fertility preferences of couples. This issue is currently more important as Iranian policy makers are revising population policies to improve fertility rate.
<strong>Objectives:</strong> As a result, the main goal of this study was to investigate factors influencing the number of desired children among married women in the reproductive age. A theoretical framework was constructed based on demographic transition theory, demand-supply theory and diffusion theory.
<strong>Methods:</strong> This study was a quantitative research and its research technique was survey. The population of the study included all married women at the reproductive age (15-49), who were living in Shiraz County (Shiraz city and surrounding rural areas). Data was collected by interviews with 626 women, who were selected by multi cluster sampling and purposive sampling during year 2014. Data was analyzed by the SPSS (version 22) software.
<strong>Results:</strong> The findings showed that the desired number of children both in Shiraz city and its surrounding rural areas was exactly below the replacement rate. In addition, findings of this study demonstrated that the desired number of children as a dependent variable is affected by a set of socioeconomic and cultural factors. Results have revealed that the main predictors are couple agreement on the number of children, respondents’ income, son preference, respondents’ authority and ethnicity.
<strong>Conclusions:</strong> Overall, the variables considered in the research model explained only 32.7% of change in the dependent variable. This means that 67.3% of change in the number of desired children is related to factors that are not included in the research model. Moreover, most of the women in Shiraz County desired to have a small family size and this fact can result in further decline of fertility rates in the future because couples respect their desires in fertility. As a result, it is recommender for policy makers to pay more attention to factors influencing the desired number of children.https://womenshealthbulletin.sums.ac.ir/article_45257_2120f5fa393bc4d908c9633ad3abc560.pdfShiraz University of Medical SciencesWomen’s Health Bulletin2345-51364220170401Assessment of Maternal Mortality and its Associated Causes at Shinyanga Regional Hospital in Tanzania174525810.17795/whb-38976ENOscar EMapundaDepartment of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, TanzaniaSia EMsuyaDepartment of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, TanzaniaKilimanjaro Christian Medical Centre, Moshi, TanzaniaCommunity Health Department, Kilimanjaro Christian Medical University College, Moshi, Tanzania000000000000000NtuliA. KapologweShinyanga Region Medical Office, TanzaniaShinyanga Regional Commissioner’s Office, TanzaniaBeatriceJohnDepartment of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, TanzaniaDamian JDamianKilimanjaro Christian Medical Centre, Moshi, TanzaniaCommunity Health Department, Kilimanjaro Christian Medical University College, Moshi, TanzaniaMichael JMahandeDepartment of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, TanzaniaJournal Article19700101<strong>Background:</strong> Maternal mortality remains a public health concern in low income countries particularly in sub-Saharan Africa where majority (62%) of maternal deaths occurs. In Tanzania maternal mortality ratio is as high as 432 deaths per 100,000 live births.
<strong>Objectives:</strong> This study aimed to describe pattern of maternal mortality ratio and its associated causes at Shinyanga regional referral hospital. We also assessed the availability of the comprehensive emergency obstetric care services in the study setting.
<strong>Methods:</strong> This was retrospective cross-sectional study which was conducted from April to May 2015 at Shinyanga Regional Referral Hospital. Information on demographic data, obstetric factors associated with maternal death and their causes as well as their management were extracted from the patient’s record file between 2010 and 2014 by using data extraction sheet. Data analysis was performed using SPSS version 18.0 for Windows (SPSS Inc, Chicago, IL, USA). Descriptive statistical analysis were summarized.
<strong>Results:</strong> Overall maternal mortality ratio declined from 635/100,000 live births in 2010 to 449/100,000 live births in 2014. The main causes of maternal death were postpartum haemorrhage (50%) and pre-eclampsia/eclampsia (20%). Majority (77%) of the delays were encountered at hospital and at home (56%). Numerous forms of management were provided to women who experienced maternal death including C-section (35.5%) for antepartum haemorrhage and hysterectomy (17%) for postpartum haemorrhage. For pre-eclampsia/eclampsia, only 12.5% had C-section. Of all of the maternal deaths, only 2.5% had assisted vaginal delivery and 14% had puerperal sepsis.
<strong>Conclusions:</strong> The observed maternal mortality ratio in this population is higher compared to the national average. Postpartum haemorrhage and preeclampsia/eclampsia remains to be the main direct causes of maternal deaths. Delay in decision making in seeking fortreatment and provision of treatment contributed to high maternal mortality observed in this study. This requires more effort to address the direct and indirect causes of maternal death.https://womenshealthbulletin.sums.ac.ir/article_45258_363286d5ab5f70b240ca1bf3455ef32f.pdfShiraz University of Medical SciencesWomen’s Health Bulletin2345-51364220170401The Relationship Between Contraceptive Methods and Common Vaginal Infections1645259ENSholehShahinfarLecturer, Department of Midwifery, School of Nursing and Midwifery, Kerman Branch, Islamic Azad University, Kerman, IranBizhanNemanpourAssistant Professor, Department of Microbiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, IranJournal Article19700101<strong>Background:</strong> Vaginitis is a common medical problem in females. Bacterial vaginosis, vulvovaginal candidiasis and trichomoniasis are the main etiologies of infectious vaginitis.
<strong>Objectives:</strong> This study was designed to assess the relationship between contraceptive methods and common vaginal infections.
<strong>Methods:</strong> In this cross-sectional study, 250 females were evaluated from December 2012 to February 2013. The researcher-made questionnaire included questions about individual characteristics and contraceptive methods. The participants underwent a gynecological exam. Specimens were collected from posterior fornix of the subjects and polymerase chain reaction assay was done to diagnose vaginitis. Data were analyzed using SPSS statistical software (version 17) and also descriptive and analytical statistics (chi-square, t test and fisher’s exact test). P values of < 0.05 were considered statistically significant.
<strong>Results:</strong> On the basis of the findings, 43.6% of females suffered from vaginitis. Overall, 65.56% of participants used contraceptive methods. Condom use was the most prevalent method of contraception. A significant relationship was found between suffering from different types of common vaginal infections and using contraceptive methods (P = 0.017). The percentage of females with candidiasis amongst hormonal contraceptive users, and the percentage of individuals amongst non-hormonal contraceptive users were higher than the others.
<strong>Conclusions:</strong> Contraceptives can increase the risk of vaginitis. Hence, health care providers should consider the probability of vaginitis in addition to the indications and contraindications of contraceptive methods and should guide couples in taking a step forward for improving their sexual and reproductive health.https://womenshealthbulletin.sums.ac.ir/article_45259_6d4f8dad7e887704f88aa0b8a2d0bd59.pdfShiraz University of Medical SciencesWomen’s Health Bulletin2345-51364220170401Acardiac Acephalus Twin Pregnancy with Poor Prenatal Outcomes: A Case Report134526010.17795/whb.42124ENSedighehAyatiDepartment of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranLeilaPouraliDepartment of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranSomayehMoeindarbariDepartment of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranMansoureh SadatGolmohammadiDepartment of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranElnazAyatiDepartment of Obstetrics and Gynecology, Tehran University of Medical Sciences, Tehran, IranJournal Article19700101<strong>Introduction:</strong> Acardiac twin refers to a monochorionic pregnancy in which there is a twin with absent or nonfunctioning heart and a normal co-twin. This was a very rare disorder of monozygotic twin pregnancy. The aim of this report was to introduce a case of acardiac acephalus twin pregnancy.
<strong>Case Presentation:</strong> A 32- year- old woman (G3 P2 L2) referred to the hospital because of a decrease in fetal movement at 32 weeks of gestation. Ultrasonography showed a dead fetus. Her earlier sonography showed the possibility of acardiac twin pregnancy, but she did not have any appropriate or special prenatal care for this problem. After delivery, there was a normal dead fetus without any gross abnormality and another acardiac fetus.
<strong>Conclusions:</strong> Early diagnosis of acardiac twin pregnancy and appropriate prenatal care are of prime importance for appropriate intervention and best fetal outcomes.https://womenshealthbulletin.sums.ac.ir/article_45260_d1ef2a4d746f9485c75cb03531f59d59.pdf