Effect of prenatal recommendations of Traditional Persian Medicine on obstetric outcomes: a randomized clinical trial

Author(s):  
Mansoor Keshavarz ◽  
Maryam Kashanian ◽  
Soodabeh Bioos ◽  
Yasaman Vazani

Abstract Background Traditional Persian Medicine (TPM) is an ancient medical system that provides suggestions to improve the health of mothers and children during pregnancy and labor. Persian physicians believed that these instructions made labor easier, safer, and less painful. Methods The present randomized clinical trial was conducted among women at 33–38 weeks of pregnancy in Tehran, Iran. TPM instructions consisted of diet, bathing, and application of oil from the 38th week of pregnancy to the onset of labor. The primary outcome was the duration of the active phase of labor. Results The mean duration of the active phase was 331.60 ± 151.48 min for the intervention group and 344.40 ± 271.46 min for the control groups, but it was not statistically significant. The active phase was significantly shorter in women who had better compliance (p=0.03). The need for oxytocin augmentation was 53.3% in the control group and 38.5% in the intervention group (p=0.17). The rate of perineal infection was 13% in the control group and 0% in the intervention group (p=0.11). Conclusions The active phase was not different in the intervention and control groups, but it was shorter in compliant women. It is possible that prolonged use of these recommendations in combination with a sitz baths and a larger sample size could result in more significant outcomes.

2020 ◽  
Vol 10 (3) ◽  
pp. 258-269
Author(s):  
Fatemeh Imani ◽  
◽  
Ebrahim Nasiri ◽  
Houshang Akbari ◽  
Mohammad Reza Safdari ◽  
...  

Objective: One of the major problems of patients after orthopedic surgeries is acute pain. The present study aims to evaluate the effect of foot reflexology massage on postoperative pain in patients undergoing plating surgery for tibia fracture. Methods: This study is a randomized clinical trial conducted on 96 patients who were candidates for tibia plating surgery referred to Imam Ali Hospital in Bojnourd, Iran, randomly divided into intervention and control groups. Foot reflexology massage in the intervention group was performed on patients’ healthy feet for 10 minutes, one hour before surgery. In the control group, the foot sole was touched for one minute without any pressure. Pain intensity was measured using the standard Visual Analog Scale before and immediately after the intervention and 2, 4, 6, 12 and 24 hours after surgery. Data were analyzed using chi-square test, t-test, repeated measures ANOVA, Mann-Whitney U and Friedman tests. Results: The baseline pain scores in the intervention and control groups were reported 8.1±0.9 and 8.4±0.9, respectively. After the intervention, the pain score in these groups was reduced to 6.9±1.1 and 8.1±1.0, respectively (P<0.001). At other times, up to 24 hours after surgery, the pain reduction was higher in the intervention group (P<0.05). Conclusion: Foot reflexology massage reduces postoperative pain of patients undergoing tibia plating surgery. Therefore, this method can be used to reduce pain and anxiety in orthopedic surgery patients.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Paria Amiri ◽  
Mojgan Mirghafourvand ◽  
Khalil Esmaeilpour ◽  
Mahin Kamalifard ◽  
Reyhaneh Ivanbagha

Abstract Background Pain control and the stress associated with labor and delivery are among the most important issues of health care system. Use of distraction techniques during childbirth is reported to reduce pain and stress of labor. However, there is a limited publication that looked on the effect of distraction techniques on labor pain and stress. Thus, the aim of this study was to determine the effect of distraction techniques on labor pain and stress (primary outcomes), fear of childbirth, length of delivery stages, first minute Apgar score and oxytocin consumption (secondary outcomes). Methods A randomized controlled clinical trial was conducted on 68 pregnant women. Participants were allocated into two groups (intervention and control groups) by blocked randomization. Participants in the intervention group received distraction techniques in four sessions. Questionnaires of Fear of Childbirth (W-DEQ version A) and PSS once were completed before intervention and again at the 36th week for the W-DEQ and in the active phase for the PSS through interviews. The pain was assessed through VAS during active phase per hour. The length of delivery stages was recorded in the partograph chart. Data were analyzed by independent t-test and ANCOVA. Results The mean of perceived stress during labor in the intervention group was significantly less than that of the control group (AMD: -3.2; 95% CI: − 0.8 to − 6.0; P = 0.01). The mean (SD) of pain intensity during labor was less than in the intervention and control groups compare to the control group (6.2 vs 7.5; P < 0.001). There was no significant difference between the two groups in terms of fear of childbirth score (AMD: 5.3; 95% CI: 13.0 to − 6.0; P = − 2.3). Moreover, there was no statistically significant difference between the two groups in terms of the active phase of labor (P = 0.504), second stage of delivery (P = 0.928), total length of delivery (P = 0.520), Apgar score (P = 1.000) and frequency of oxytocin consumption (P = 0.622). Conclusion According to the results, distraction techniques can reduce the pain and stress of labor, but further studies by using the distraction techniques are needed to reach a decisive conclusion. Trial registration IRCT2017042910324N39; Name of registry: Iranian Registry of Clinical Trials; Registered 11 September 2017. URL of registry: https://fa.irct.ir/user/trial/10814/view. Date of enrolment of the first participant to the trial: September 2017.


2018 ◽  
Vol 7 (3) ◽  
pp. 393-399
Author(s):  
Solmaz Babazadeh Topraghlou ◽  
Fahimeh Sehhatie Shafaie ◽  
Mojgan Mirghafourvand ◽  
Narges Salehi

Objectives: The shortened duration of labor without creating major complications is considered ideal for the mother and infant while prolonged labor is accompanied by maternal and fetal consequences. Considering its importance, the purpose of this study was to compare the effects of acupressure at the Hugo point and hyoscine on the duration of labor stages and fetal-neonatal outcomes in nulliparous women. Methods: This controlled randomized clinical trial was conducted on 162 nulliparous women who referred to Ardabil Sabalan Hospital in 2017. Participants were divided into Hugo acupressure, hyoscine, and control groups by means of randomized blocks, each containing 54 nulliparous women. In the Hugo group, the pressure exerted on the Hugo point at 5 cm dilatation and in the hyoscine group, the hyoscine was injected intramuscularly at 5 cm dilatation. Data were analyzed using one-way ANOVA, KruskalWallis, Fisher exact, and chi-square tests. Results: The mean (SD) duration of the active phase of labor was 137.0 (15.1), 143.3 (172), and 187.7 (24.7) minutes in the Hugo, hyoscine, and control groups, respectively. In addition, the mean (SD) duration of the second stage of labor in the above-mentioned groups was 39.5 (8.5), 52.4 (15.0), and 58.3 (8.7) minutes, respectively (P<0.001). Conclusions: Overall, the implementation of acupressure at the Hugo point led to a greater reduction in the duration of labor stages compared to hyoscine infusion without imposing the side-effects on mother.


2019 ◽  
Author(s):  
Paria Amiri ◽  
Mojgan Mirghafourvand ◽  
Khalil Esmaeilpour ◽  
Mahin Kamalifard ◽  
Reyhaneh Ivanbagha

Abstract Background: Pain control and the stress associated with labor and delivery are among the most important issues of health care system. Use of distraction techniques during childbirth is reported to reduce pain and stress of labor. However, there is a limited publication that looked on the effect of distraction techniques on labor pain and stress. Thus, the aim of this study was to determine the effect of distraction techniques on labor pain and stress (primary outcomes), fear of childbirth, length of delivery stages, first minute Apgar score and oxytocin consumption (secondary outcomes). Methods: A randomized controlled clinical trial was conducted on 68 pregnant women. Participants were allocated into two groups (intervention and control groups) by blocked randomization. Participants in the intervention group received distraction techniques in four sessions. Questionnaires of Fear of Childbirth (W-DEQ version A) and PSS once were completed before intervention and again at the 36th week for the W-DEQ and in the active phase for the PSS through interviews. The pain was assessed through VAS during active phase per hour. The length of delivery stages was recorded in the partograph chart. Data were analyzed by independent t-test and ANCOVA . Results: The mean of perceived stress during labor in the intervention group was significantly less than that of the control group (AMD: -3.2; 95% CI: -0.8 to -6.0; P= 0.01). The mean (SD) of pain intensity during labor was less than in the intervention and control groups compare to the control group (6.2 vs 7.5; P<0.001). There was no significant difference between the two groups in terms of fear of childbirth score (AMD: 5.3; 95% CI: 13.0 to -6.0; P= -2.3). Moreover, there was no statistically significant difference between the two groups in terms of the active phase of labor (P= 0.504), second stage of delivery (P= 0.928), total length of delivery (P= 0.520), Apgar score (P= 1.000) and frequency of oxytocin consumption (P= 0.622). Conclusion: According to the results, distraction techniques can reduce the pain and stress of labor, but further studies by using the distraction techniques are needed to reach a decisive conclusion .


2021 ◽  
Author(s):  
Alireza Hashemi Shiri ◽  
Esmaeil Raiatdoost ◽  
Hamid Afkhami ◽  
Ruhollah Ravanshad ◽  
Seyed Ehsan Hosseini ◽  
...  

AbstractBackgroundGiven the COVID-19 pandemic’s, researchers are beseeched for effective treatments. Herbal medicine is also queried for potential supplementary treatments for COVID-19. We aimed to evaluate the effects of Sugarcane, Black Myrobalan, and Mastic herbal medications for COVID-19 patients.MethodsThis was a double-blinded randomized clinical trial study conducted over three months from May to July 2020 in patients admitted with a diagnosis of COVID-19 in Peymaniyeh Hospital in Jahrom, Iran. The intervention group received the treatment protocol approved by the Ministry of Health of Iran during the period of hospitalization and the herbal supplement obtained from the combination of black myrobalan and mastic and sugarcane, twice a day (3g of herbal supplements). All patients were compared in terms of demographic variables, vital signs, clinical and laboratory variables.Results72 patients with COVID-19, divided into intervention (n=37) and control (n=35) groups. intervention and control groups had not any significant difference in terms of baseline characteristics. The time-to-event analysis revealed a significant difference in 4 symptoms of cough, fever, dyspnea, and myalgia (P<0.05). The Control group had a significantly lower decrease in C-reactive protein during 7 days (P<0.05). Patients in the herbal supplement group were hospitalized for 4.12 days and in the control group were hospitalized for 8.37 days (P=0.001). ICU admission and death only happened in 3 (8.6%) patients of the control group.ConclusionWhile advanced studies with more sample size are needed; the proposed combination seems to be effective in the symptom treatment and reducing the length of hospitalization.


2021 ◽  

Objective: Silkworm cocoon produced by silkworms with the scientific name of Bombyx mori L. is a well-known medicinal agent mainly composed of proteins. This study was designed to assess the efficacy of syrup made from this natural agent on mild to moderate depression. Design: The study was designed as a triple blind randomized clinical trial (RCT). Sixty patients with mixed anxiety–depressive disorder (MADD) were randomized to receive either intervention (silk syrup plus sertraline) or control (placebo syrup + sertraline) for a period of 12 weeks. Depression and anxiety were assessed by using the Beck depression and anxiety inventories at weeks 0, 6 and 12. Results: Fifty-four patients completed the trial in two groups of intervention (n = 30) and control (n = 24) and entered final analysis. According to the results of this study, the mean of anxiety and depression in weeks 6 and week 12 in the intervention group was significantly lower than the control group (p<0.001). Conclusion: Silk syrup can be beneficial for management of anxiety and depression in mild to moderate MADD. Thus, it is suggested as an adjuvant treatment to increase efficacy of conventional drugs in MADD patients.


Author(s):  
Shereen B. Elbohoty ◽  
Ayman S. Dawood ◽  
Ahmed M. Abbas ◽  
Adel E. Elgergawy

Background: Caesarean delivery (CD) rates in developing countries are rising beyond the recommended rates of World health organization. Objective of this study was to evaluate whether Dexamethasone injections reduce neonatal incubation admissions when given before scheduled caesarean delivery (CD) at term or not.Methods: A double blinded, two armed, randomized clinical trial was conducted at Tanta University hospitals in the period from October 2017 to March 2019. Four hundred pregnant women admitted for scheduled CD with gestational age ≥37 weeks were included. Patients were randomized into study group and control group. The study group was given 3 dexamethasone doses, 8 mg each while control group was given saline injections simultaneously as a placebo drug. The primary outcome was the neonatal incubatory admissions.Results: Demographic data in both groups were comparable. Transient tachypnea of newborn (TTN) was 15.47% in study group versus 20.33% in control group with p=0.227. The respiratory distress (RDS) in study group was 6.63% versus 9.89% in control group with p=0.260. The incubation admissions were nasal oxygen 12.71% versus 15.38%, continuous positive airway pressure ventilation (CPAP) 5.52% versus 8.24% and mechanical ventilation was 3.87% versus 6.59% in the study and control groups respectively.Conclusions: Although Dexamethasone administration before scheduled CD at term reduced both respiratory morbidity and incubation admissions, the differences between study and control groups were not significant.


2021 ◽  
Author(s):  
Leigh Ann Simmons ◽  
Jennifer Phipps ◽  
Courtney Overstreet ◽  
Elizabeth Bechard ◽  
Siwei Liu ◽  
...  

Abstract Background: Excess gestational weight gain (GWG) is associated with many pregnancy complications and health risks for mothers and infants. Likewise, postpartum weight retention (PPWR) has long-term health consequences for women. Excess GWG among women who enter pregnancy with overweight or obesity have worse obstetric outcomes and increased PPWR compared to women who gain within Institute of Medicine guidelines. Methods: This study is a blinded, randomized clinical trial of GROWell: Goals for Reaching Optimal Wellness, a mHealth tool designed to improve diet quality among women who enter pregnancy with overweight or obese BMIs in order to help them achieve appropriate GWG and safe postpartum pregnancy weight loss. Overweight and obese (BMI B25 and <40) women with singleton, uncomplicated pregnancies will be recruited and randomly assigned to an attention control or intervention arm. The intervention group will receive goal-oriented text messages regarding dietary choices, while the attention control group will receive text messages about healthy pregnancy, labor, delivery and early infancy. Both groups will complete online surveys at baseline (26-28 weeks), follow up (36-38 weeks), 3 months postpartum, and 6 months postpartum.Discussion: This study protocol describes the details of the GROWell randomized clinical trial. The results of this trial will provide data to support the use of an evidence-based mHealth tool to be integrated into clinical practice to reduce excess GWG and PPWR among pregnant women with overweight and obese BMIs, a resource that is currently lacking.Trial registration: ClinicalTrials.gov identifier: NCT04449432. Registered on June 26, 2020.


2019 ◽  
Vol 7 (4) ◽  
pp. 118-121
Author(s):  
Haleh Bodagh ◽  
Zahra Esfahani ◽  
Naser Aslanabadi ◽  
Bita Amiri ◽  
Ali Heidari Sarvestani

Introduction : Allopurinol could decrease the undesirable effects of free radicals and then prevent contrast induced nephropathy (CIN). Therefore, it may be useful for reducing the ischemia-reperfusion induced nephropathy and inhibiting nitric oxide synthesis produced in CIN. This study was performed aimeing to determine the effect of allopurinol in the prevention of CIN in patients undergoing angioplasty. Methods: In this randomized clinical trial, 100 patients (50 cases as the intervention group receiving allopurinol 300 mg one day and one hour before angiography and 50 cases as the control group) were evaluated. CIN was considered if the serum creatinine (SCr) value was increased 25% in relation to its basic value. Additionally, the prevalence of CIN was evaluated. Results: The case and control groups had CIN 38% and 12%, respectively (P = 0.003). Hyperuricemia was significant indicator of higher CIN rate in the control group (37.5% versus 7.1%) (P = 0.044). Conclusion: Finally, the administration of allopurinol before procedure might prevent CIN following elective percutaneous coronary intervention (PCI) and decrease the rate of CIN.


2021 ◽  
Author(s):  
Rakesh Sarwal ◽  
Rajinder K. Dhamija ◽  
Khushbu Jain ◽  
Ishwar V Basavaraddi

Background: The global outbreak of COVID-19 has created a challenging situation, especially among the frontline Health Care Professionals (HCPs), who are routinely exposed and thus at a relatively higher risk of infection. A few studies have shown the practice of Pranayama, a component of Yoga, to be effective in improving immune function and reducing infection. However, no clinical trial on the efficacy of Pranayama in preventing COVID-19 has been conducted.Aim &amp; Objective: This randomized clinical trial assessed the effect of Pranayama in preventing COVID-19 infection in Health Care Professionals (HCPs) routinely exposed to COVID-19 cases.Methodology: The study was conducted at 5 different COVID-19 hospitals in New Delhi, India during September-November, 2020. 280 HCPs assigned duties with COVID-19 patients who were found negative in COVID-19 antibody test in pre-intervention assessment were recruited and randomly assigned to intervention and control groups. The intervention group practiced especially designed Pranayama modules twice a day (morning and evening) for 28 days under the supervision of Yoga instructors through online mode, while those in the control group were advised general fitness practices (like walking, jogging, running). Participants who became symptomatic underwent RTPCR / Point of Care Rapid Antigen test for confirmation of COVID 19 diagnosis. All the patients also underwent antibody testing for COVID-19 on 28th day of the intervention to detect asymptomatic infection.Results: 250 participants, comprising 123 in the intervention group and 127 in the control group, completed the study . The intervention and control groups had comparable demographics and baseline characteristics. Three participants (all controls) developed COVID 19 symptoms during the study. On the completion of the study, only one participant in the Intervention group tested positive, while 9 participants in the control group (Including three symptomatic participants) tested positive for COVID-19 antibodies. This difference was statistically significant (P-value: 0.01). Conclusion: Practice of our especially designed Pranayama module, every day for 28 days was highly effective in preventing COVID-19 infection in exposed healthcare professionals (HCPs).


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