Reproductive Tract Infections—A Main Factor Influencing Women’s Mental Status: Comparison on Depression and Anxiety between Naxi Women with and without RTIs

Objectives 1) To explore the relationship between RTIs and mental status of Naxi women; 2) to compare the differences of depression & anxiety between Naxi women who have and not have RTIs; and 3) to put forward some suggestions for improving Naxi women’s reproductive health in psychological point of view. Methods A cross-sectional survey was adopted, 280 married Naxi female volunteers who aged above 20 years old were selected by cluster random sampling from the two selected villages of Lugufu Township of Yanyuan county in Sichuan. Two selfreporting scales, CES-D and SAS were used for assessment of depression and anxiety of the subjects. Results The facts of mental status of Sichuan Naxi women brook no optimism. Among 280 Naxi reproductive age women who were investigated in current study, only 74 (26.4%) have no depression symptoms, and 116 (41.4%) have no anxiety symptoms. For the study population, the average total scores (TS) of CES-D was 20.1, and the average total index scores (TIS) of SAS was 50.2, and both of them were above a minimum value doubted to have symptoms. There were big differences of both average TS of CES-D and TIS of SAS between Naxi women who have and not have RTIs. Further analysis revealed that RTI was a main risk factor influencing women’s mental status (OR=16.043 for depression, and OR=12.954 for anxiety). In addition, Naxi women’s depression and anxiety were related to order births (≤ 2, OR=3.149, 95% CI: 1.228, 8.076), sex debut was younger (≤ 17, OR=3.043, 95% CI: 1.895, 4.884), and multiple pregnancy (≥ 3, OR=2.728, 95% CI: 1.990, 4.173), etc. Conclusion For improving Naxi women’s mental status, a pressing matter of themoment is for local medical persons to gain the knowledge about mental health and the diagnosis and treatment levels of psychological disorders. At the same time, psychological counselling should become a main activity of reproductive health services.

A Survey of Correlation Infertility Self-Efficacy with Behavioral Health Scales in Infertile Women

Background: Infertility is a unique medical challenge that can have health behavioral consequence on infertile women including lack of self-esteem, depression, anxiety, fertility problem in infertile couples. The aim of this study was to evaluate correlation between self-efficacy and health behaviors scales in infertile women. Methods: A cross sectional study was conducted on 89 infertile women with mild to moderate depression (Beck scores 10 - 47) who were recruited from Fatemeh Zahra Infertility and Reproductive Health Research Center. All participants completed Self-efficacy Inventory (ISE) and other health behavioral scales (e.g., the Beck Depression Inventory (BDI), Cattle Anxiety Scale (CAS), Fertility Problem Infertility (FPI), and GHQ). Pearson correlation coefficient and Spearman rho correlation coefficient were used to analyze the data. Variables were included in the study if they had a p-value

Teaching reproductive endocrinology in Iran: Pilot assessment of hospital-based clinical modules for medical students at Tehran University of Medical Sciences

This pilot study evaluated effectiveness and acceptance of a new hospital-based reproductive endocrinology curriculum among Iranian medical students. A voluntary, anonymous questionnaire was used to compare two teaching methods as applied to junior medical students at Tehran University of Medical Sciences. Students were randomly assigned to one of two clinical teaching settings;no student experienced both modules. Coursework for the pilot (experimental) group (n = 19) utilized a teaching approach comprising lectures, genetics laboratory, pelvic ultrasound, small group sessions, and opportunities to observe advanced reproductive technologies such as in vitro fertilization, ICSI, and embryo transfer. A control group (n = 34) received reproductive endocrinology instruction by the ‘traditional curriculum’, consisting mainly of lectures. Students were sampled at baseline and again atthe conclusion of their reproductive endocrinology session. Pre- and post-test data were analyzed for both groups;post-test differences between groups were also compared. No significant differences in mean age or gender mix were identified between the two study groups. Overall, the ques- tionnaire did not identify any significant intergroup differences for any parameter investigated. Although student acceptance rate appeared similar for both educational modules, the ratio of students having a “favorable regard” for reproductive medicine declined only among students randomized to the control group (41.2% vs. 32.3%). This report offers the first data on teaching reproductive endocrinology to medical students in Iran. Both traditional and innovative approaches to teaching reproductive endocrinology were well-accepted by students, although negative post-test responses were more common among students in the control group. While periodic quality assessments for existing clinical teaching methods are necessary, introduction of alternative teaching approaches is also important. Additional studies are planned to evaluate the impact this initiative may have on results on standardized tests measuring reproductive endocrinology knowledge, as well as election of further specialization in training.

The Role of Moral Intelligence and Identity Styles in Prediction of Mental Health Problems in Healthcare Students

Background: Assessment of healthcare students’ mental health problems is an important aspect of health promotion. This study examined the roles of moral intelligence (MI) and identity styles in prediction of mental health problems in healthcare students. Methods: In a correlation study, two hundred healthcare students (100 girls, 100 boys) of Medicine, Density, and Paramedicine Colleges of Bobol University of Medical Sciences were selected. The subjects filled out three questionnaires;General Health Questionnaire (GHQ-28), Moral Competency Inventory (MCI), and Identity Style Inventory (ISI), and General Health Questionnaire (GHQ-28). Pearson correlation, multivariate analysis variance model (MANOVA), and multivariate regression used to analyze the data. Results: Boys and girls did not have a meaningful difference in the mean of total GHQ, MCI, normative and informational identity. Girls had significantly higher mean level of diffused-avoidant identity than boys. There was a positive and significant relationship between moral intelligence, normative identity and mental health problems of students. Also, there was a negative relationship (p < 0.05) between diffused-avoidant identity and mental health problems of students. Moral intelligence, informational and normative identity predicted 25.8% of the variance in mental health problems for girls’ students. Normative and diffused-avoidant identity predicted 21.6% of the variance in mental health problems for girls’ students. Conclusions: This study demonstrated that moral intelligence and identity status contributed to the mental health problems of healthcare students. University administrators should adopt strategies that strengthen the moral intelligence and identity maturity associated with university students’ mental health.

Female anterior wall onlay urethroplasty with lower lip buccal mucosal graft: Importance of the laterally extended incision

Objective:To describe the outcome of female anterior wall(pubic side)onlay urethroplasty with buccal mucosal graft using laterally extended surgical dissection in patients with previously failed minimally invasive techniques.Methods:From January 2016 to April 2018,17 symptomatic patients with previously failed minimally invasive procedures were enrolled in the study.The diagnosis of urethral stricture was confirmed based on a combination of patients’symptoms,post-void residual urine,video-urodynamics,and cystoscopy.Urethroplasty with lower lip mucosal graft was performed using the modified laterally extended dissection.Patients were evaluated pre-operatively and 12-month post-operatively with the American Urological Association symptom score,post-void residual urine,and maximum flow rate.Results:Despite the previously failed minimally invasive procedures,urethroplasty with lower lip buccal graft and laterally extended dissection resulted in favorable outcomes(success rateZ94%).The mean
standard deviation of American urological association symptom score improved from pre-operative levels at the 12-month post-operative follow-up(25.82
3.97 to 10.88
5.57);so did postvoid residual urine(71.12
74.98 mL to 15.00
28.30 mL),and maximum flow rate(7.88
1.72 mL/s to 25.82
5.59 mL/s)with all statistically significant(p<0.05).Conclusion:The current study showed that female urethroplasty with buccal graft could be highly successful in experienced hands.An anterior approach could be superior to the posterior one due to higher mechanical support and lower sacculation rate.A laterally extended incision may improve visualization and better graft placement by providing wider working space.The results should be evaluated in the future studies with larger sample size.

A comparison of the effect of Vitamin D and Vitamin E supplementations,alone,and in combination,on reducing the intensity and duration of dysmenorrhea in women:A randomized controlled trial

Objective:The aim of this study is to compare the effect of Vitamin D and Vitamin E supplementations,alone,and in combination,on reducing the intensity and duration of dysmenorrhea in women who were referred to the Kowsar gynecological clinics of Shahid Motahari Hospital of Urmia University of Medical Sciences.Materials and Methods:A double-blinded clinical trial was conducted on 112 women with dysmenorrhea who were randomly allocated into the four study groups.Finally,100 women complete the study and received capsules containing a placebo(n=25),1000 IU of Vitamin D(n=25),400 mg of Vitamin E(n=25),and 1000 IU of Vitamin D+400 mg of Vitamin E(n=25)every 24 h for 2 consecutive months at the beginning of the menstrual period.The pain intensity and duration among groups were compared before and after the intervention.Results:The mean menstrual pain duration in all three experimental groups(Vitamin E,Vitamin D,and the combination of them)was lower than the placebo group(all P<0.05),and the mean pain intensity scores in all three experimental groups were significantly lower than the placebo group(all P<0.05).The results(means)for all of the drugs administered at the end of the 2nd month were better than the 1st month(all P<0.01).Conclusions:Vitamin E and Vitamin D,as well as their combination,are recommended as an effective and safe treatment for the management of the complications of dysmenorrhea.

Effect of perineal massage on the incidence of episiotomy and perineal laceration

Background: Perineal traumas particularly caused by following vaginal delivery are associated with short and long term morbidity for women. Therefore, interventions that increase the probability of intact perineum are necessary. The aim of study was to determine the effect of perineal massage with a sterile lubricant on the incidence of episiotomy and perinea laceration. Materials: This clinical trial study was performed on 145 nulliparous women who referred to Amol Emam Ali teaching center for normal delivery. They were randomly participating in interventional group (massage with lubricant) (45 cases) or control group (100 cases). In massage group when they progressed to full dilatation of the cervix, the midwife inserted two fingers inside vagina and using a sweeping motion gently stretched the perineum with lubricant 5 up to 10 minutes, in and between mother’s pushing in the second stage of labour. In control group just Ritgen Maneuver was applied. At last, we compared the rate of intact perineum, episiotomy and laceration, mean duration of the second stage of labor and Apgar score in 1 and 5 minutes between two groups. Statistical analyses were performed using t-test, Chi Square to determine potentially significant associations, and a p value less than 0.05 was considered significant. Results: The incidences of intact perineum, episiotomy and laceration were 22.2% (10), 44.4% (20), 33.3% (15) respectively in interventional group. In control group, intact perineum, episiotomy and laceration were: 20.2% (20), 49.3% (71), 28.3% (28) respectively. This difference was not statis- tically significant. Rate of first-degree laceration was 33.3% (15) in massage group, while this percent was 28.3% (28) in control group. This difference was not statistically significant. In massage and control groups, second, third and fourth-degree lacerations did not occur. Conclusion: The results showed that massage with a sterile lubricant provides no apparent and significant advantage or disadvantage in reducing perineal trauma. Therefore, the use of massage as technique for perineal control is safe based on labour criteria and woman’s preference during delivery.

Is coping strategies predictor of anxiety and depression in couple infertile?

Background: Infertility is a complex crisis of life and increases psychological difficulties such as anxiety and depression. Identification of copy strategies for stressful events like infertility is important. The aim of our study was to investigate the relationship between coping strategies with anxiety and depression symptoms in men and women’s infertile. Methods: This descriptive-analytic study was conducted from 2011-2012 on 168 Iranian infertile couples referred to the Fatemeh Zahra infertility and reproductive health research center of Babol university of medical science to initiate assistant reproductive technologies and completed the Ways of Coping Questionnaire (WCQ), The State-Trait Anxiety Inventory (STAI), and Beck Depression Inventory (BDI).The results were analyzed using t-test, the Pearson correlation and the stepwise model of multiple regression analysis. P Results: Escape/ avoidance contributed the greatest amount of unique variance to the model for anxiety/de-pression of infertile women (P < 0.0001, P < 0.001) and followed by distancing (P < 0.0001, P < 0.01), accepting responsibility(P < 0.0001, P < 0.01). Seeking social support was the negative significantly predictor for both anxiety and depression in infertile women (P < 0.01, P < 0.01), but planful problem solving was the inversely predictor for only depression in infertile women (P < 0.01). Escape/avoidance was the only predictor factor of the model anxiety for infertile men (P < 0.01). Escape/avoidance and self controlling were the positive predictor (P < 0.001) and planful problem solving was the negative predictor for men depression (P Conclusion: men and women infertile who use disproportionally maladaptive coping strategies such as escape/avoidance are predisposed to anxiety and depression symptoms. How using the coping strategies is very important in expressing anxiety and depression in infertile couples and training the adaptive coping strategies suggested by counseling centers.

Hyponeurotrophinemia in Serum of Women with Polycystic Ovary Syndrome as a Low Grade Chronic Inflammation

Introduction: This study aimed to discuss about neuroimmune-pathophysiology of polycystic ovary syndrome (PCOS). Nerve growth factor (NGF) as modulator of neuro-endocrine-immune (NEI) system plays a critical role in tissue survival and homeostasis maintenance. It is a strong marker for sympathetic nerve activity. Women with PCO have enhanced ovarian NGF production. Over the past few decades, PCOS has been discussed as a low grade chronic inflammatory disease. In this study, we investigated the neuromodulator role of serum NGF and inflammatory cytokines (IL-1α, β, 17A and TNF-α) in women with PCOS. Material and Methods: 171 patients were investigated in two groups: study (n = 85 PCO) and control (n = 86). Serum levels of NGF-α and interleukins IL-1α, IL-1β, IL-17A and TNFα were determined in both groups by ELISA kit. Results: Data of this study showed that the level of NGF-α and IL-17A in serum of PCO women were lower than control group (p α, IL-1β were higher than control group in PCO women (p < 0.001). Conclusion: Probably inflammatory background in PCOS is the main cause of increased serum levels of IL-1α, IL-1β. Reduction of IL-17A and NGF in serum of PCO patients might be under the direct influence of the hyperactivity of sympathetic nervous system (SNS).

Comparison of Depression and Anxiety between Unmarried Female Youth in Two Groups of Induced Abortion and None-Induced Abortion in Yibin City of China

Objectives To explore the risk factors influencing the mental status of unmarried female youth. Methods A cross-sectional survey and a qualitative interview were adopted. 1 200 unmarried female volunteers (600 with IA) who aged 15-29 years in Yibin city were investigated, and 8 focus group discussions (FGDs) and 8 in-depth interviews were conducted. Except the investigation of subject’s personal information, econ-socio status, sexual behavior, contraception and reproductive health problems they face, two self- reporting scales, CES-D and SAS were used for assessment of depression and anxiety of the subjects. Results 1) Depression and anxiety among unmarried female youth investigated in current study are relatively common. Proportions of the females with depression and anxiety to the total sample are 27.4% and 33.4%, respectively; 2) Depression and anxiety of the females with IA are more serious than that of the female without IA. Proportions of unmarried females with IA have depression and anxiety to the total unmarried females with IA are 3.45 times and 2.61 times that of unmarried females without IA have depression and anxiety to the total unmarried females without IA, respectively; 3) IA is one of the key risk factors influencing depression and anxiety of unmarried female youth. Other risk factors are lack on basic knowledge about sex/ STD/HIV/AIDS, reproductive tract infections, relatively lower income, age at sex debut is relatively younger, etc. In addition, multiple sex partners and repeat pregnancieswere risk factors influencing anxiety of unmarried female youth. Conclusion Depession and anxiety was more popular in unmarried females with IA. Intervention for improving mental health of unmarried females should be developred.

Synchrony between Ovarian Function &Sleep in Polycystic Ovary Syndrome Patients

Polycystic ovary syndrome (PCOS) is a complex, multifaceted, heterogeneous disorder, affecting 4% to 18% of reproductive-aged women and is associated with reproductive, metabolic and psychological dysfunction. In this study we determined the relationship between the time to sleep and serum levels of neurohormones in polycystic ovary syndrome (PCOS). Totally 77 PCO patients(case group) and 97 non-PCOS infertile women (control subjects) participated in this study between February 2012 and February 2013. A PSQI sleep questionnaire was completed by each patient in both groups. PSQI sleep questionnaire score and serum concentration of adrenaline, noradrenaline, melatonin, β-endorphin, cortisol and progesterone were compared in two groups. The results of the study indicate that serum levels of melatonin and β-endorphin were lower in women with PCOS. Serum level of stress hormones, adrenaline and noradrenaline were significantly correlated with patients’ sleep time in study group. Serum level of adrenaline in control group was significantly lower in women who wake up earlier in the morning. All hormones except for cortisol had no significant correlation with PSQI global score in both groups and also the people who sleep less than 8 hours had lower cortisol level. These data showed that changes in cortisol in PCO women were due to damage of disturbed sleep at night. Our preliminary work provided this study with new insight into the interactions between sleep-wake cycles in PCO women with specific sleep patterns.

Hepatitis B and pregnancy: An update review article

Chronic hepatitis B, as a global health problem, is a disease that begins in the prenatal period and its complications gradually become clear later in life. About 5% of women worldwide are carriers of chronic hepatitis B virus(HBV). The most common method of transmission of HBV around the world is from mother to infant. This article aims to review the unique challenges of hepatitis B in pregnancy. Data for this review were collected from our previous studiesand experiences plus various data banks, such as Pub Med, EMBASE, ISI Web of science, Scopus, Google Scholar and Iranian databases. A comprehensive search was performed using the combinations of the keywords to review relevant literature and higher education journals. All published data up to February 2014 have been included in this review. This article addresses several interesting aspects. First, hepatitis B in pregnancy can vary regarding prevalence, virus behavior, prenatal transmission and outcome of the pregnancy. Second, the women of reproductive age with chronic HBV remain a major source for continued spread of the virus. Finally, pregnant women need screening in prenatal care to enable early intervention when necessary.

Effect of hydro-alcoholic extract of Olea europaea on apoptosis-related genes and oxidative stress in a rat model of torsion/detorsion-induced ovarian damage

Objective: To evaluate the impact of Olea (O.) europaea extract on markers of oxidative stress and apoptosis of ovarian tissues in a rat model of torsion/detorsion-induced ovarian damage. Methods: A total of 28 Wistar female rats were randomly assigned into 4 groups, with 7 rats in each group. The sham group received a 2.5 cm longitudinal incision in the midline part of the abdomen which was then sutured with 5-0 nylon thread;the torsion/detorsion group underwent torsion induction for 3 h followed by reperfusion for 10 days;the torsion/detorsion+O. europaea group received 300 mg/kg hydro-alcoholic extract of O. europaea 30 min before detorsion, followed by reperfusion for 10 days;and the O. europaea group only received 300 mg/kg hydro-alcoholic extract of O. europaea for 10 days. After the treatment period, blood samples were taken;the levels of estrogen, glutathione peroxidase, superoxide dismutase, and malondialdehyde were assayed. The histological changes, as well as the rate of apoptosis in ovarian tissues, were also carried out by histomorphometric analysis at day 10 post-procedure. Results: Histological comparisons demonstrated a significant detrimental change in the torsion/detorsion group as compared with other groups. The number of pre-antral and antral follicles and corpus luteum was significantly decreased in the torsion/detorsion group compared with the sham group, while treatment with O. europaea could enhance their numbers (P<0.05). The index of apoptosis and the number of atretic body in the ovarian tissue were significantly higher in the torsion/detorsion group compared with the sham group (P<0.05). The concentrations of glutathione peroxidase, estrogen, and superoxide dismutase as well as the mRNA expression of Bcl-2 were considerably diminished in the torsion/detorsion group while they were elevated in the torsion/detorsion+O. europaea group (P<0.05) compared with the torsion/detorsion group. The serum malondialdehyde level and the mRNA expression of Bax were markedly increased during ischemia, while treatment with O. europaea significantly diminished the increased concentrations of malondialdehyde and Bax level in the torsion/detorsion+O. europaea group (P<0.05). Conclusions: O. europaea extract can reduce the degree of tissue damage induced by oxidative stress and apoptosis in the ovary following ovarian ischemia/reperfusion.

Test anxiety in objective structured clinical examinations (OSCEs) compared with traditional assessment methods in undergraduate midwifery students

BACKGROUND: Final comprehensive exam is the most important examination for midwifery students to evaluate their professional ability and Test anxiety is a common phenomenon among college students. Because test anxiety is one of the problems of educational systems, this study was performed to compare test anxiety in objective structured clinical examinations (OS-CEs) and traditional assessment methods (TAM) among Undergraduate Midwifery Students. Methods: In this descriptive-analytical study, 52 students of Babol Midwifery College were participated in the study. 20 students were evaluated using TAM in November 2010, and 32 students were evaluated using the OSCE method in July 2011. Data were collected via a two-component questionnaire including demographic data and the test anxiety inventory (TAI). Results: All of midwifery students were women;the mean age of students, ages of father and mother’s were 23.1 ± 0.7, 52.3 ± 3.5 and 47.8 ± 4.9 years, respectively. Most of the students were single (61.5%). The mean education levels of father and mother’s were 11.6 ± 4.5 and 9.9 ± 4.0 years, respectively. The mean score of test anxiety in students was 42.51 ± 13.16. The most of participants did have moderate test anxiety (56.9%), two present not had any test anxiety, 37.3% had low test anxiety, and 3.9% had severe test anxiety. In sum, 98% had some degrees of test anxiety. There were the statistical differences in the mean score of text anxiety in OSCEs Compared with TAM in Undergraduate Midwifery Students (39.38 ± 13.81 vs. 47.35 ± 10.67, P = 0.033). Also, the mean severity of anxiety was different in two groups. The mean of moderate/severe test anxiety was more in TAM compared with OSCEs (52.57% vs. 49.56%, p = 0.000). The test anxiety had a positive correlation with father’s education, mother’s education (0.286, p = 0.042), father’s age, mother’s age, marital status, residency (0.292, p = 0.042). Also, there are negative correlations with student age, satisfaction, total Grade Point Average (GPA) (-0.387, p = 0.007), final score, type of assessment (-0.298, p = 0.033). There is a significant difference between the severity anxiety residency in total (p = 0.10) and OSCEs (p = 0.049) groups, mother’s education in total (p = 0.005) and OSCEs groups (0.012) and GPA (p = 0.028). Conclusion: OSCEs were superior to TAM in the reduction of test anxiety in midwifery students. The prevalence of test anxiety was in TAM than OSCEs method;therefore, using OSCEs is acknowledged as an effective assessment tool and is seen as the gold standard for evaluating clinical performance.

Association of Lifestyle Factors and Sperm Motility in Adults from an Ethnic Minority Region of Southwest China

Objectives: To understand sperm motility in adults and its association with lifestyle in an ethnic minority area in Southwest China. Methods: A hospital-based cross-sectional study to assess sperm motility in male adults was conducted at the Reproductive Health Center from January 2018 to May 2019. The data was collected with a questionnaire and semen quality was analyzed with Computer-Aided Sperm Analysis system (CASA). Analysis of covariance (ANCOVA) was used to measure the relationship between lifestyle factors and sperm motility. Results: A total of 349 people were recruited. Dietary celery intake was significantly related to the increase of sperm progressive motility and total motility (β = 7.00, 95% CI: 1.59, 12.42 and β = 7.26, 95% CI: 1.45, 13.07, respectively). Cola consumption was associated with increased sperm progressive motility (β = 9.71, 95% CI: 1.46, 17.96). Frequent use of plastic bags for meat food storage (β = -5.56, 95% CI: -10.61, -0.51), industry work (β = -5.64, 95% CI: -11.21, -0.07), organic disease (β = -6.14, 95% CI: -11.00, -1.28) and sedentary lifestyle (β = -5.92, 95% CI: -10.66, -1.17 for 3-5 h/d and β = -6.04, 95% CI: -11.60, -0.47 for ≥5 h/d, respectively) were related with the decreased sperm progressive motility. Meanwhile, using plastic bags for meat food storage (β = -6.37, 95% CI: -11.79, -0.95), industry work (β = -7.96, 95% CI: -13.94, -1.98) and sedentary lifestyle (β = -5.51, 95% CI: -10.60, -0.42 for 3-5 h/d and β = -6.03, 95% CI: -12.01, -0.06 for ≥5 h/d, respectively) were also risk factors for total motility. Conclusions: Some modifiable lifestyle factors such as job title, cola consumption, dietary celery intake, plastic bags for meat food storage, and sedentary hours were linked to male sperm motility, indicating that changing these lifestyles may improve it.

Comparison of Sexual Function in Primiparous Women Pre-Pregnancy and Postpartum: Difference of the Sexual Function after the Normal Vaginal Delivery and the Cesarean Section

Introduction: Sexual function is undoubtedly an important dimension of adult life. Due to all the conflicting results with regard to sexual function after the normal vaginal delivery (NVD) or the Cesarean Section (CS), in the present study, we aimed to compare the sexual function in women pre-pregnancy and postpartum and also after the NVD and CS. Materials and Methods: In this cohort study, two groups of healthy women, with antenatal normal pregnancies, who underwent NVD (n = 90) and CS (n = 113), were prospectively studied. The sexual function of the participants was assessed through a Female Sexual Function Index (FSFI) questionnaire in two stages: once before pregnancy and then within 3 to 6 months after delivery, which lasted from June 2011 to September 2012. The data were analyzed by descriptive and inferential statistics. Data were analyzed using chi-square test, Mann-Whitney test, and T Test. Results: Based on the data gathered from 206 women who completed the FSFI questionnaire in two stages, the mean (±SD) self-reported timing of the resumption of sexual activity was 8.9 ± 1.3. There was no significant statistical difference found between the two groups by timing of the resumption of sexual activity in NVD and CS groups. There was also no statistically significant difference found in the overall sexual function scores between the two groups (NVD vs. CS). The average score for female sexual function in desire, arousal, orgasm, and satisfaction within 3 to 6 months after delivery was significantly lower than that of their pre-pregnancy period (p < 0.004). The mean coitus in postpartum period was 1.84 ± 1.20 per week. Conclusion: Based on the findings of this study, there was no significant relationship between the mode of delivery and changes in sexual function. Therefore, it can be claimed that CS is not preferred to NVD with regard to preserving normal sexual functioning.

Improving Sexual and Contraceptive Behaviours of Unmarried Female Youth with First Trimester Induced Abortion in Sichuan,China

Objectives To understand the changes on sexual and contraceptive behaviours of unmarried induced abortion(IA) youth by intervention in Sichuan, China; and to find a way to improve sexual and contraceptive behaviours of unmarried IA youth. Methods Intervention epidemiological surveys (baseline and evaluation) plus quali- tative interview were used. During July 2002 and July 2003, 2 484 unmarried female volunteers who aged 15-29 years and come to clinics seeking abortion were recruited by cluster random sampling from the four selected regions of Sichuan, 48 volunteers were interviewed for 8 focusgroup discussions (FGDs) and 16 in-depth interviews equally for each survey. Information, education anol communication(IEC) materials, education sessions, trainings and counseling were given to subjects and service providers during the project implementation. Questionnaires for surveys and guidelines for qualitative interviews were used. Results Comparison of the after with the before intervention: 1) the proportion of respondents having knowledge about sexuality was increased by 13%. Among them, the proportion of respondents got part and most of the knowledge was increased by 43%. Maximum number of sex partners the respondents have decreased from 9 to 4. Respondents’ partnerships have gradually changed from more acquaintances/ school mates/ boy friends to fiancés mainly; 2) respondents’ contraceptive use rate was in-creased by 20%. Among them, the condom use rate increased rapidly to 80%. Purposes of condom use were changed from only for contraception to for prevention of HIV/AIDS/STDs and pregnancy. And most of respondents stabilised their method use - condoms. Most of respondents suggested condoms was the method most suitable for unmarried IA youth, this proportion was increased by 44%; 3) proportion of respon- dents knowing more about consequences of induced abortion was increased by 24%; and 4) proportions of respondents having depression and anxiety symptoms were decreased by 66% and by 61%, respectively. Conclusion The intervention including IEC materials, education, training and coun- seling was effective in improving sexual and contraceptive behaviours of unmarried IA youth.

Germline cells derived from mesenchymal stem cells, with the focus on Wharton's jelly

Previous attempts have indicated that mesenchymal stem cells (MSCs) are a valuable source and candidate and new approach for tissue engineering and reproductive medicine. MSCs have this potential to be induced and differentiated in an appropriatein vivoandin vitro condition toward various cell lineages and then they can be applied in cell therapies and clinical applications. During recent two decades, various sources have demonstrated they are a great source for MSCs, including bone marrow, the human umbilical cord as well as Wharton's jelly. Due to discarding after birth, easily accessible cells and less ethical concerns, these cells have attracted more and more scientists' attention. Infertility and reproduction diseases have provided special opportunity to examine the efficiency of MSCs in this kind of application. Based on recent investigations, MSCs embedded in Wharton's jelly tissue are more appealing for cell therapies, especially in infertility treatment purposes. So, differentiation of MSCs embedded in Wharton's jelly tissue into germ layer cells for cell-based therapy purposes is now under intensive study.

Expectant Management of Preterm Ruptured Membranes before 34 Gestational Weeks at the University Hospital of Kinshasa, a Tertiary Referral Hospital in the Democratic Republic of Congo

Premature Rupture of Membranes (PROM) with the resulting prematurity remains a major public health issue in the Democratic Republic of Congo (DRC). This study aimed to assess expectant management of PPROM before 34 weeks at the university hospital of Kinshasa. We conducted a retrospective analysis of expectantly managed PROM before 34 weeks between January 2008 and December 2018. Maternal and fetal outcomes were collected, and all data were analyzed using the SPSS 23.0 software. Of the 113 patients included in the study, 2.6% were diagnosed with PROM before 34 weeks. We observed prolongation of the pregnancy duration;the median latency period was eight days, and the average gestational age at delivery of 32.85 ± 2.5 weeks. Chorioamnionitis (23%), severe oligoamnios (7%), and acute fetal distress (4%) were complications observed during the latency period. In the postpartum period, endometritis (6.2%), neonatal jaundice (39.8%), anemia (25.7%), ulcerative necrotizing enterocolitis (6.2%), cerebromeningeal hemorrhage (5.3%), and acute respiratory distress syndrome (4.4%) were complications observed. The risk of infection during the latency period was significantly associated with irregular (P = 0.045) or lack (P = 0.006) antenatal care (ANC) attendances and C-Reactive Protein (CRP) results 6 (P = 0.013). The risk of neonatal death was significantly associated to infection during the latency period (P = 0.011), irregular (P = 0.009) or lack of ANC (P = 0.000) attendances, Birth weight g (P = 0.039) as well as Gestational age at birth between 28 to 30 Weeks (S) (P = 0.021). These findings report first-time pregnancy outcomes related to the management of PPROM before 34 weeks in our setting. We found that the conservative attitude adopted allowed the prolongation of pregnancies, reducing the risks associated with prematurity. Nevertheless, attendance in good quality ANC could reduce the frequency of PROM and related adverse outcomes.

Correlation of Nitric Oxide (NO) and Corticotrophin Releasing Hormone (CRH) between Normal Pregnancy and Preeclampsia

Preeclampsia is still a major cause of maternal death in pregnancy which needs efforts to prevent and early detection. Nitric oxide and Corticotrophin Releasing Hormone has an important role in the pathogenesis of preeclampsia to determine differences in concentrations of NO and CRH in normal pregnancy and preeclampsia, as well as to study the correlation both on the incidence of preeclampsia. This is a cross sectional study. Blood samples obtained from patients with preeclampsia (30 samples) and normal pregnancies as controls (30 samples) in accordance with inclusion and exclusion criteria. NO concentration was examined with essay protocol, and CRH concentrations with ELISA method. Then be calculated by statistical analysis: chi square, t test, Mann-Whitney, and Spearman Rank correlation coefficient. Based on statistical analysis, there was no significant difference (p > 0.05) from the characteristics of maternal age, pregnancy weeks, and parity in both study groups, so the two groups of homogeneous and comparable. The mean concentration of NO in preeclampsia was lower (3.780 μM) compared with normal pregnancy (13.360 μM). There was significant correlation between NO and CRH concentrations in normal pregnancy and preeclampsia (p < 0.001). The involvement of NO/c-GMP pathway is very possible in the pathogenesis of preeclampsia.