Investigating the Impact of Cognitive-Behavioral Stress Management on Adjustment among Females with Breast Cancer

Background and Aim: This study aimed to investigate the effect of cognitive-behavioral stress management (CBSM) on adjustment among females with breast cancer. Materials and Methods: This randomized clinical trial study was conducted on 104 women with breast cancer who visited Hamedan Imam Khomeini Clinic between Feb 3 and Oct 26, 2016, and met the inclusion criteria. The inclusion criteria included being 20 to 60 years old, being married, and having grade 1-3 breast cancer with a history of recent surgery. The subjects were randomly assigned to two groups of 52 subjects, using a permuted block size of 4. The intervention group participated in 4 sessions of CBSM, each 90 minutes long, for a duration of 4 weeks. Data collection was done using a demographic information questionnaire and Bell adjustment questionnaire. The statistical analyst remained unaware of the intervention assignment. Data analysis was done using descriptive statistics, paired t-test, and repeated measures ANOVA. Results: There was a significant difference in the mean scores of the total adjustment (P = 0,0001) between the two groups after the intervention. Each variable was calculated three times, prior to the intervention, immediately after and 2 weeks after the intervention. Regardless of the time of measurement, there was a significant difference in the mean score of total adjustment between the two groups (P = 0.0001). Conclusion : The cognitive-behavioral stress management program improved the adjustment immediately and 2 weeks after the intervention was done among women with breast cancer. This method can be implemented as a complementary approach along with medical therapies provided by oncology centers.

A Copeptin as a Predictor Marker for Insulin Resistance Among Women with Polycystic Ovary Syndrome

Background: A polycystic ovarian syndrome (PCOS) is a common endocrine syndrome in which women have a wide range of clinical presentations; insulin resistance was linked to its pathogenesis. Objective: We aimed to investigate the copeptin role as a predictive marker of insulin resistance among PCOS women. Material and Methods: In University Hospital, we included 280 women, with 140 of them being healthy controls. 140 out of 280 cases of PCOS subdivided into two groups depending on the insulin resistance; group 1 with homeostasis model assessment for the insulin resistance < 2.5. Group 2 with homeostasis model assessment for the insulin resistance >2.5. The evaluation of body mass index and blood pressure for all besides the blood sampling for estimation of a follicular stimulating hormone, luteinizing hormone, prolactin, estradiol, sex hormone-binding globulin, total testosterone, fasting insulin dehydroepiandrosterone sulfate, C-reactive protein, plasma glucose, free androgen index, and plasma copeptin using the Copeptin-Human EIA Kit besides the transvaginal ultrasound for ovarian assessment. Results: When compared to other groups, PCOS women with positive insulin resistance >2.5 had a significantly higher plasma copeptin level. The ROC curve calculated a 1.94 pmol/L; plasma copeptin cutoff value for detecting the insulin resistance in PCOS with 88% sensitivity value and 36% specificity, AUC was 0.88. Conclusion: The significant positive relationship between serum copeptin and insulin resistance with high sensitivity implies its usefulness as a marker of insulin resistance among PCOS patients with a high prediction of its complication.

Breastfeeding Self-Efficacy and Its Relationship with Perceived Stress and Breastfeeding Performance in Iranian Mothers with Late Preterm Infants: A Prospective Study

Background: Late preterm infants suffer from several problems after birth, and the key factor in fighting these problems is effective breastfeeding. Objective: To determine breastfeeding self-efficacy and its relationship with perceived stress and assess breastfeeding performance in mothers with late preterm infants Methods: In this prospective study, 171 eligible nursing mothers with late preterm infants born in Alzahra Medical Center of Tabriz, Iran, were selected via convenience sampling. The Breastfeeding Self-Efficacy Scale-Short Form was employed to measure breastfeeding self-efficacy, and the 14-item Perceived Stress Scale was used to measure the perceived stress 24 hours after giving birth. When the child was 4 months old, breastfeeding performance was measured by the Standard Breastfeeding Performance Questionnaire. The data were analyzed by Pearson and Spearman’s correlation tests, independent t-test, one-way ANOVA, and multiple linear regression analysis. Results: The mean (standard deviation) of breastfeeding self-efficacy was 50.0 (7.8) with scores ranging from 13 to 65, and the mean (standard deviation) of perceived stress was 26.5 (8.8) with scores ranging from 0 to 56. The median (25-75 percentiles) of breastfeeding performance score equaled 2.0 (1.0 to 3.0) with scores ranging from 0 to 6. Based on multiple linear regression analysis and after adjusting the personal-social characteristics, by increasing the score of breastfeeding self-efficacy, perceived stress was significantly decreased (B=-0.1, 95%CI=-0.3 to 0.0). However, there was no statistically significant relationship between breastfeeding self-efficacy and breastfeeding performance (p=0.418). Conclusion: Due to the possibility of adjusting breastfeeding self-efficacy and its role in mothers’ perceived stress, developing proper strategies seems to be essential for enhancing breastfeeding self-efficacy.

Safe abortion practice and knowledge on abortion legalization among Nepalese undergraduate female students

Background: Unsafe abortion remains one of the major public health problems, especially in developing countries. The objective of this study was to assess the level of knowledge on the legalization of abortion and the practice of abortion among Nepalese undergraduate female students. Methods: An analytical cross-sectional study was conducted among the 490 female students of Pokhara Valley, Nepal. Study populations from the 10 colleges were selected through purposive and systematic random sampling. The semi-structured questionnaire was used as a data collection technique. Results: Only 34% of students have a good knowledge of abortion legalization, compared to 42% who have poor knowledge. While two-thirds of the participants (66.6%) were aware that abortion is legal in Nepal, only a few were aware of the conditions for legalized safe abortion. During sexual intercourse, almost half of the participants (51.3%) did not use any form of contraception. Unintended conception was the primary cause of abortion (53.3%). Conclusion: The level of knowledge about the abortion law, safe abortion practice, and utilization of abortion services were found to be poor. Age of the participant, autonomy level for decision making, religion, and study background were the associated factors with the level of knowledge and practice of abortion. Community-based health promotion and awareness programs focusing on the youth population should be conducted.

Assessment of Pattern, Determinants and Treatment Practices of Menstrual Disorders among Medical Undergraduate Students

Background: Menstruation-related symptoms (MRSs) have been observed to result in absenteeism from either work or education, more commonly among women below 21 years than women of any other age group. Despite its high prevalence and associated ill effects, it is generally ignored even by medical students. Objectives: This study was conducted to assess the pattern, determinants, and treatment practices of menstrual disorders among undergraduate medical students. Methods: This was a cross-sectional study conducted among 215 female medical students from first to final year. Data were collected by using a self-administered questionnaire. The height and weight of participants were measured using standard procedures. Results: The most common menstrual disorders reported by participants over the past six months were dysmenorrhoea [191(88.8%)] followed by irregular cycles [43(20.0%)]. In multivariable analysis, the presence of polycystic ovarian syndrome (PCOS) and excessive consumption of coffee was associated with irregular menstrual cycles; the presence of anaemia was associated with menorrhagia, the presence of fibroids and age of participants ≤18 years were associated with polymenorrhoea, excessive chocolate consumption was related to intermenstrual bleeding, excessive chocolate consumption, presence of anaemia, and low body mass index (BMI) were associated with premenstrual syndrome. Self-medication was reported by 15 (42.9%) out of the 35 participants on treatment. Conclusion: Dysmenorrhea, menstrual irregularities, and premenstrual symptoms were common among participants. They need to limit potential risk factors like excessive consumption of coffee and chocolates. Additionally, screening for anaemia, PCOS, fibroids and low BMI needs to be done. Self-medication practices need to be also dissuaded in the setting.

Attention action needs to be taken in regard to the Dietary Intake of Pregnant Women in Amman

Background: Women experience a significant increase in nutritional needs during pregnancy due to the several changes during this phase. Failure to meet these increased nutritional needs may cause irreversible effects and predispose outcomes to metabolic complications. Scarce data to establish the base of nutritional status among pregnant women in Jordan was available. Objective: The study aimed to assess and evaluate energy and nutrients consumption among a group of pregnant women in Amman Governorate during the second or third trimesters; in order to compare the consumption with “Recommended Dietary Allowance” (RDA). Methods: A cross-sectional study was carried out in 2018 at the Ministry of Health’s (MoH) Maternal and Children Health Centers (MCHC) in Amman to assess the dietary intake for a convenient sample of 300 seemingly healthy pregnant women aged between 17 and 40 years-old and at ≥ 13 weeks of gestation. Maternal demographic cheracteristics, medical history, anthropometric measurements and dietary data (three days recall) were collected. Results: The daily mean intake of carbohydrates exceeded the recommended intake for 45.3% of pregnant women. Fiber intake was less than 28g/day for 90% of them. Total fats intake (45.6g/day) was lower than the RDA for 42.3% of the pregnant women. Two-thirds of the pregnant women consumed a moderate amount of saturated fats (14.6g/day). The mean daily intake of proteins was 50.5±20.2g. More than two-thirds consumed protein less than the RDA; subsequently, intakes of all essential amino acids were below RDAs. The intake of fat-soluble vitamins was lower than RDA for vitamins D, E, and K.While, the intake of vitamin A, was higher than RDA. The intake of minerals was lower than RDA for (calcium, fluoride, iodine, iron, zinc, and selenium), while the intakes of sodium and copper were higher. Conclusion: The results showed inadequate and imbalanced dietary intake in comparison with RDA. Maternal nutrition and diets of pregnant women in this study show alarming indicators that may negatively affect the well-being of both pregnant women and fetal growth.

The association between maternal COVID-19 and the rates of cesarean: A systematic review

Background: Maternal COVID-19 infection has been reported to be associated with an increase in the rates of C-sections. However, studies have not reported this association consistently. Therefore, this systematic review and meta-analysis were conducted regarding this issue. Methods: We identified all publications up to January 2021 in databases of PubMed, Scopus, and Web of Science. In addition, we reviewed gray literature and conference proceedings. The pooled odds ratios (OR) and 95% confidence intervals (CI (measured from eligible studies were used as random effect estimates of association among studies. Heterogeneity testing using I2 statistics was performed to assess variance between the studies. Results: The pooled estimates of OR did not report a significant association between COVID-19 and the risk of cesarean section, respectively (OR = 2.02, 95% CI = 0. 4 to 3.64). There was low heterogeneity among the studies reporting the risk of diseases associated with cesarean section among children based on OR (I2=12.7%, P=0.333). The P values for Begg’s and Eggerʼs regression were 0.573 and 0.555, respectively. Conclusion: While we did not find an association between COVID-19 and increased rates of cesarean sections, we cannot exclude a type II error; therefore, additional studies, including large cohort studies by controlling confounding variables, should be performed in the future.