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Background: The growing elderly population in Iran and the association of aging with the high prevalence of physical and mental disorders have increased the necessity of determining quality of life of this age group. The quality of life of elderly women is affected by several factors due to their vulnerability. Hence, this study was designed to investigate the quality of life of elderly women in Arak.

Materials and Methods: This cross-sectional study was carried out on 271 elderly women who lived in Arak in 2013 using classified sampling. Data were obtained via general QOL (SF-36) questionnaires and analyzed by SPSS software.

Results: The mean (±SD) age of the participants was 67.5±7.02 years. The mean (±SD) total scores of SF-36, mental health, and physical health dimensions were 50.22±18.39, 58.54±19.38, and 46.35±20.82, respectively. The mean (±SD) score of eight dimensions of QOL were: general health 45.52±10.79, social function 56.58±24.94, physical pain 47.60±28.27, physical function 51.46±27.05, physical limitation 38.10±42.67, emotional problems 46.22±42.11, vitality 50.16±19.09, and mental health 58.54±19.38. There were significant difference between QOL, marriage, and income (P<0.05).

Conclusion: The results showed that the quality of life in this study was average and some factors, such as education, income, marriage, and residential situation, have a direct influence on QOL.

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Background: Cancer is one of the most common causes of deaths in the world. Cancer incidence and prevalence is increasing in the world. There is no clear trend is available on incidence of these cancers in Iran, therefore, this study aimed to determine the incidence of 10 common cancers among Iranian women from 2003 to 2009.

Materials and Methods: A cross-sectional study was conducted by analyzing existing data. Data from a national registry of cancer cases were received. Data included the records from the cancer registry system in Iranian women during 2003 to 2009. The incidence rates were then standardized using direct method. We used Cochrane Armitage Test for linear trend by Winpepi software to determine the variation in the incidence of cancers.

Results: The results show that the proportion of all cancers is rising in women as compared to all population. Breast, skin, colorectal, gastric, esophageal, thyroid, leukemia, ovary, brain and uterus were the most common cancer among Iranian women. During the years of the survey, these cancers are significantly increased.

Conclusion: The results of this study showed that the incidence of cancer in women is increased. screening programs can be useful in reducing the cancers.

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Background: Episiotomy is one of the most common gynecologic surgery that was done in the second stage of labor, in order to facilitate the delivery. Cutting this area is associated with pain and discomfort. Healing causes pain relief and returning to daily activities became faster. Considering that the high rates of episiotomy infection, we decided to examine the effect of topical cream, saffron 20%, on women who had undergone episiotomy.

Materials and Methods: This randomized, double-blind clinical trial study was performed on 60 primiparous women in 2013-2014 who underwent vaginal delivery and episiotomy at in Taleghani Hospital of Arak. Intervention group recieved 20% topical cream containing saffron extract three times daily for 2 weeks and the control group received a placebo cream. Wound status and its healing were investigated in the first, seventh and fourteenth postpartum.

Results: There was a significant difference between both groups with healing of episiotomy location in seventh(p=0.54) and fourteenth(p=0.003) days and the continuity process of the wound edges in the first (p=0.015), seventh(p=0.013) and fourteenth(p=0.001) days. there was no statistically significant difference about the opening the wound in the first day(p=0.492), There was a statistically significant difference between the two groups in seventh(p=0.001) and fourteenth(p=0.026) days.

Conclusion: This study showed that saffron extract cream 20% can be effective for episiotomy wound healing and wound edges continuity.

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Background:  The aim of this study was to investigate the effect of resistance training with different intensities on serum myostatin and follistatin levels in sedentary young women.

Materials and Methods: In this practical and semi experimental study, 24 sedentary young women with range of 20-30 years and BMI 22-25 kg/m² were selected by convenience sampling. Then, the volunteers were randomly assigned into two groups, [resistance training group with low intensity (40-60% of one repetition maximum) and high intensity (70-90% of one repetition maximum)]. The training protocols included: 8 weeks, 3 times a week. Blood samples (5cc) were obtained at baseline and 48 hours after at the end of the study; Also Serum levels of myostatin and follistatin were measured by ELISA methods. Data were analyzed using analysis of variance of repeated measures test by SPSS at the significant level (p<0.05).

Results: There was a significant increase in the levels of follistatin and follistatin to myostatin ratio in high intensity group (p≤0.05). Also there was a significant decrease in the levels of myostatin in high intensity group (p≤0.05); however, there was no significant change in the levels of follistatin, myostatin and follistatin to myostatin ratio in low intensity group (p≥0.05). Also there was no significant change in these variables in high intensity group compared to low intensity group (p≥0.05).

Conclusion: It’s seems that the activation of important myogenic and myostatic factors in sedentary young women need to do high intensity resistance training.

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Abstract

Background: Diabetes mellitus is a common disease in human societies that dealing with its complications imposes enormous cost to the health system. The previous studies have shown that bone biochemical markers can be used for evaluation of bone metabolism in response to physical activity. The purpose of this study was to examine the effect of increasing 10-week aerobic exercise (AE) on serum osteocalcin, PTH and glycemic and anthropometric indices in postmenopausal women with type II diabetes.

Materials and Methods: In this semi-experimental study, 40 postmenopausal women with type II diabetes (40-60 years) as available subjects were selected and randomly assigned into two exercise (20) and control (20) groups. Exercise protocol was AE and walking activity for 10 weeks (3d/wk, 45 to 60 min/d with 45% to 60% HRRmax intensity). Blood samples were taken before and after exercise to measure serum variables. Data were analyzed by T-test and statistical significance criterion was set as p<0.05.

Results: AE makes a significant increase in osteocalcin levels and a decrease in insulin resistance index, insulin and fasting blood glucose in the experimental group (p<0.05). Changes in other variables such as PTH, HbA1c and anthropometric indices were not significant (p>0.05).

Conclusion: Due to the favorable effects of AE on osteocalcin and glycemic indices, it seems that this training method can be recommended as a non-invasive treatment for maintaining bone density and controlling blood glucose in diabetic patients.

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Background: Self-medication is one of the biggest problems of social, health and economic societies such as Iran. The aim of this study was to determine the benefits and barriers about self-medication among women referring to health center in Qom city.  

Materials and Methods: This cross-sectional descriptive-analytical study carried out on women referred to health centers in Qom city- 2016. In the current study, 226 people were selected from among the health centers by multistage sampling. A standard questionnaire was used on knowledge about self-medication, perceived benefits, perceived barriers and self-medication. Data were analyzed by SPSS V.20 using independent t-test and Chi-square.

Results: According to the results of this study, 74.3 percent of women had a history of self-medication that 43.8 percent of them was in the past 6 months. The mean of knowledge about self-medication and perceived barriers in people with a history of self-medication was significantly higher than those who had not a history of self-medication (p<0.05). While, the perceived benefits was not significantly associated with a history of self-medication (p=0.79).

Conclusion: Given the high prevalence of self-medication and the relationship between knowledge and perceived barriers with self-medication, therefore, educational program is necessary for women about the effects and consequences of self-medication through the media.

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Background and Aim: In Iran, one quarter of couples experience infertility, which can affect various aspects of their marital life. The aim of this study was to compare psychological characteristics in fertile and infertile women referring to health centers and an infertility center in Qom. Materials and Methods: This descriptive-analytical cross-sectional study was carried out on 160 women. of all, 80 women were selected via simple random sampling method and were among those in reproductive age who referred to health centers to receive routine childcare services. The other 80 women were selected via simple random sampling method among infertile women who referred to the infertility center. The required data were collected using standard anxiety, depression, and marital adjustment questionnaires. Data were entered into SPSS V.20 software and were analyzed using Fisher’s exact test, independent t-test and Chi-square. Findings: There were a significant difference between the two groups in terms of the mean scores of depression (p=0.005), anxiety (p=0.02), and marital adjustment (p=0.01), as the mean score of depression and anxiety was higher in fertile women than in infertile women. However, the mean score of marital adjustment was higher in infertile women than in fertile women. Conclusion: Since fertility can be dependent on psychological factors and other underlying factors of an individual, therefore, it is necessary to consider the educational needs of fertile and infertile women.

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Background and Aim: Women are the central pillar of social development and the main axis of family health. Success, survival, and promotion of society depend on the health of women in society. Since Health Promotion lifestyle and psychological well-being are important determinants of health, this study was conducted to determine the Health Promotion lifestyle and psychological well-being in women attending the health centers of Arak City in 2019.
Methods & Materials: In this cross-sectional study, among women who attended health centers in Arak City, 221 women who met the inclusion criteria were included in the study by continuous sampling and the form of demographic information, health promoting lifestyle profile-Ii (HPLP-II), and Ryff Psychological well-being Questionnaire was completed. Data were described using descriptive statistics of frequency, frequency percentage, mean, standard deviation, and data analysis by analysis of variance, independent t-test, and regression using SPSS software v. 19.
Ethical Considerations: This study was approved by the Ethics Committee of Research Deputy of Iran University of Medical Sciences (Code: IR.IUMS.REC.1398.609).
Results: The mean health-promoting lifestyle in the study units was 135.96; the mean physical activity components were 16.31; The mean nutrition was 26.41, with the lowest and highest scores, respectively. The mean psychological well-being in the study units was 72.29. The mean components of purpose in life were 10.76, and the mean personal growth was 13.19, with the lowest and highest scores, respectively. Age, chronic diseases, employment, number of children, and alcohol consumption had a significant negative relationship with a health-promoting lifestyle, and a woman’s and her husband’s education had a significant positive relationship with a health-promoting lifestyle (P<0.05). Overall demographic variables predict as much as 13% of health-promoting lifestyles. Age, number of children, and chronic physical and psychological diseases had a significant negative relationship with psychological well-being and economic status. A woman’s and her husband’s education had a significant positive relationship with psychological well-being. Overall, demographic variables predict as much as 10% of psychological well-being. 
Conclusion: Considering that health-promoting lifestyle and psychological well-being are two critical determinants of health, studying these two indicators and the factors affecting them can help Intervention planning to promote women’s physical and mental health.

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Background and Aim: A lack of healthy nutrition first causes prediabetes and then overt diabetes, and every year about 5% to 10% of people with glucose intolerance develop type 2 diabetes. This study aimed to assess the factors affecting the consumption of healthy foods (CHF) based on the food pyramid among prediabetic women based on the Theory of Planned Behavior (TPB).
Methods & Materials: This cross-sectional study was conducted in 2019 on 99 prediabetic women selected from comprehensive healthcare centers in Arak, Iran. A demographic questionnaire, a TPB-based questionnaire, and a food consumption Questionnaire were used for data collection. Data were analyzed through Spearman’s correlation and linear regression analyses.
Ethical Considerations: This study was approved by the Research Ethics Committee of Arak University of Medical Sciences (Code: IR.ARAKMU.REC.1398.07).
Results: The Mean±SD score of diet behavior was 1.34±0.28 (in the possible range of 0-2). Around 41% of participants consumed sugary foods such as sweets and chocolate at least once a week and 35% at least once a month. Regression analysis shows that by increasing a standard deviation in the behavioral intention score, the behavior score of a healthy diet will increase by 0.22 standard deviation (P<0.05).
Conclusion: To achieve a healthy lifestyle in the individual at risk for a diabetics education program to increase perceived behavior and motivation for decision making for adherence to healthy food can be attention for policymakers in a health system.

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Background and Aim Physical activity has multiple health benefits, but its association with fertility in women is still unknown. Considering the critical effects of lifestyle on reproductive health, this study aims to compare the physical activity and body composition of fertile and infertile women.
Methods & Materials This is a case-control study that was performed on 100 fertile and 100 infertile women aged 20-40 years referred to the infertility treatment centers in Arak, Iran. they completed self-reported questionnaires surveying sociodemographic characteristics and lifestyle, and the International Physical Activity Questionnaire (IPAQ) assessing physical activity and sedentary behavior. Anthropometric characteristics and body composition were also measured. Multiple logistic regression analysis was used to analyze the association of fertility with physical activity level, sedentary behavior, and body composition.
Ethical Considerations This study was approved by the Ethics Committee of the University of Arak University of Medical Sciences  (Code: IR.ARAKMU.REC.1400.050).
Results The level of physical activity (P=0.001) was lower and the body mass index (P=0.03) was higher in infertile women than in fertile women. In women with moderate level of physical activity, the risk of infertility was lower (OR=4.42, 95% CI: 1.60-12.99, P=0.004). Women who spent the time sitting for more than 300 minutes a day were 2.07 times more likely to have fertility than women who were physically active (OR=2.07, 95% CI: 1.36-3.14, P=0.001).
Conclusion Low physical activity, sedentary lifestyle and obesity are independent risk factors of infertility. To prevent infertility, more attention should be paid to the lifestyle of women.

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Introduction: The purpose of this study was to compare the effectiveness of cognitive-behavioral therapy and motivational interviewing on self-esteem in divorced women.
Methods: The current study was a semi-experimental pre-test and post-test design. The statistical population consisted of 260 divorced women aged 20 to 50.  60 women were selected based on the inclusion criteria and randomly assign to three groups of cognitive-behavioral therapy, motivational interview therapy and control group. The instrument of data collection was Rosenberg Self- Esteem Questionnaire. For the experimental groups, 12 sessions of 75 minutes were held. No intervention was done for the control group. Before the interventions and at the end of the study, people in all groups filled out the questionnaire. The data was analyzed using SPSS version 25 software and analysis of covariance (ANCOVA).
Results: There was a significant difference between the three groups of cognitive-behavioral therapy, motivational interview and the control group in the comparison of the mean score of self-esteem variables (P<0.05). Also, in the one-by-one comparison of the cognitive-behavioral therapy and motivational interview therapy groups with the control group, there was a significant difference in the post-test stage (P<0.05).
Ethical considerations: In this research, the principle of confidentiality, preservation of personal information and non-disclosure of the identity of the participants were ensured and it was reminded that the obtained information will only be used statistically.
Conclusions: The findings indicate that cognitive-behavioral therapy and motivational interviewing are effective in enhancing self-esteem in divorced women. It suggests that these two methods are used along with other psychological and pharmaceutical therapies for divorced women as a clinical intervention.

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Background: Today, infertility is a major concern for public health and one of the most important crises in life, which leads to many psychological problems. Since cognitive-behavioral therapy emphasizes empowering and educating the patient to solve problems, this study was conducted to investigate the effectiveness of cognitive-behavioral therapy on marital self-regulation and uncertainty intolerance in infertile women.

Methods:  This clinical trial study was performed on 30 infertile women referring to the infertility center of Sari city in two groups of case and control (15 patients in each group). Cognitive-behavioral therapy was performed in 12 sessions of 45 minutes, once a week for the experimental group, while the control group received the routine treatment. After the follow-up period, the control group also underwent psychotherapy. Both groups completed the questionnaires of marital self-regulation by Wilson et al. (2005) and uncertainty intolerance by Friston et al. (1994) in the pre-test, post-test and follow-up (45 days after the post-test) and were compared.

Finding: The results showed that in the two subscales of marital self-regulation in the experimental group, the average scores in the three stages of pre-test, post-test and follow-up respectively for the subscale of communication self-regulation (24.266 ± 6.273), (41.000 ± 3.207) and (35.266 ± 3.899) there was a significant increase in the post-test and follow-up compared to the pre-test stage(P<0.05). And the sub-scale of communication effort(19.333 ± 5.094), (8.666 ± 1.914) and (12.000 ± 2.449), and intolerance of uncertainty 92.600 ± 9.302), (67.400 ± 7.585) and (75.200 ± 10.975), had a significant decrease in the post-test and follow-up compared to the pre-test stage (P<0.05).

Conclusion: The results of the study showed that cognitive-behavioral therapy can be an effective intervention in improving marital self-regulation and reducing intolerance of uncertainty in infertile women.


 

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Introduction: Despite the adverse consequences of cesarean delivery, its incidence rate is increasing in many provinces of the country, especially Ilam city. For this reason, it is important to identify the causes of the increase in cesarean delivery in order to reduce it. Therefore, the present study was conducted with the aim of determining the frequency of cesarean section and its causes in primiparous women in Ilam city in 2016.
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Methodology: The present study was conducted cross-sectionally in the second half of 2016 in Ilam city, and the study population was all primiparous women referred to a single specialty maternity hospital (Ayatollah Taleghani Hospital). The sampling method was census and all cesarean deliveries were recorded in Ayatollah Taleghani Hospital. The inclusion criteria included all primiparous women. The data of the study was collected using a researcher-made questionnaire that included demographic and midwifery information. After collecting the data, the data was entered into the SPSS version 16 software Central indices were used to describe data in quantitative variables, and absolute and cumulative frequency and percentage of dispersion frequency were used for qualitative variables.
Findings: According to the findings of this study, out of 1738 births, 867 (49.88%) were natural births and 871 (50.12%) were cesarean. Among the natural births, 427 (49.25%) and among the cesarean births, 296 (33.98%) were primiparous. Among the maternal factors, lack of progress and among the fetal factors, fetal distress and among the maternal-fetal factors, head-to-pelvis disproportion was one of the most important causes of cesarean delivery in primiparous women. In general, fetal factors with more than 67% were the most important causes of caesarean section in primiparous women.

Conclusion: According to the findings of the study, 33.98% of cesarean births were primiparous. Considering the high statistics of caesarean section, especially cesarean section for first births , It is necessary to reduce the number of elective cesarean sections by increasing the number of physiological births and painless births, as well as increasing the awareness of families about birthing methods and the advantages and disadvantages of each of them.
 

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Introduction: The process of the first pregnancy causes a decrease in resilience and fear of pain, which requires interventions to solve these problems. This study aimed to determine the effectiveness of group therapy spirituality on endurance and pain control in primiparous pregnant women.
Methods: The research method was semi-experimental, pre-test, and post-test with a control group. The statistical population of this study included all pregnant women who gave birth in 2022 in the city of Kerman, 30 people (15 people in the experimental group and 15 people in the control group) were selected by the available sampling method. The data collection tools were the pain disability questionnaires of Mold and the resilience questionnaires of Connor and Davidson. A group spiritual therapy intervention was performed on the experimental group, and the control group did not receive any intervention. Data analysis was done with descriptive tests (mean and standard deviation) and covariance analysis. A P value less than 0.05 was considered significant.
Results: In the resilience variable, the mean and standard deviation of the experimental group in the pre-test was 41.27 ± 7.22 and the post-test 63.18 ± 8.69. In the pain control variable, the mean and standard deviation of the group in the pre-test was 35.73 ± 6.28, and the post-test was 21.40 ± 5.44. The results showed that group therapy spirituality had an effect on endurance and pain control in primiparous pregnant women (P < 0.01).
Conclusions: Based on the findings of the research, group therapy spirituality can be used to increase endurance and control pain in primiparous pregnant women.

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Introduction: Sexual self-efficacy is a fundamental concept in behavior, health, and sexual performance that changes over time due to events such as pregnancy and childbirth. The present study was conducted to investigate factors affecting sexual self-efficacy in pregnant women in Arak City.
Methods: The current research is a cross-sectional, descriptive, and analytical study conducted with 234 pregnant women aged 18 to 40 who had minimal reading and writing literacy and lived with their husbands. Ten comprehensive urban health centers were selected using cluster sampling. Data were collected through a demographic information checklist and a sexual self-efficacy questionnaire. Data analysis was done using Mann-Whitney U and Kruskal-Wallis and (LSD) tests.
Results: The mean score of sexual self-efficacy of pregnant women was 28.51 ± 6.45 and was at a high level. Kruskal-Wallis test showed that the sexual self-efficacy of pregnant women is unrelated to their education (P = 0.2). There is a significant relationship between education and the education of their spouses (P = 0.04). (LSD) test showed a significant difference between different levels of education of husbands and the sexual self-efficacy of pregnant women. Also, no significant relationship was observed between the mean score of sexual self-efficacy and other variables.
Conclusions: The sexual self-efficacy of pregnant women is related to the education of their husbands, so it is suggested to provide a suitable platform for increasing the knowledge and awareness of men.

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Introduction: For many people, infertility is a prominent crisis and cause of mental stress that causes many unfavorable psychological reactions. The purpose of the research is to design a cognitive-behavioral coping training package with the stress of infertility and its effectiveness on the hope of infertile women.
Methods: The present study was conducted using a mixed method using the qualitative part, content analysis type, and the quantitative part, semi-experimental, in the pre-test-post-test-two-month follow-up design with the control group. The statistical population of this research was infertile women referring to infertility centers and gynecology and infertility specialists in Kermanshah in 2022. A sample of forty women was selected as a sample using the purposeful sampling method and replaced in two groups (experimental and control) in a simple random manner. Data were collected from Newton et al.'s infertility stress questionnaire (1999) and Schneider's Hope (1991). The data was analyzed using a content validity test and repeated measurement variance analysis tests.
Results: The designed educational package was valid and adequate. The findings showed a significant difference between pre-test, post-test, and follow-up in the component of hope, and this difference continued until the follow-up stage.
Conclusions: The educational package on cognitive-behavioral coping with the stress of infertility of infertile women can be used to reduce the stress and increase the hope of infertile women.

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Introduction: Considering the synthesis and secretion of irisin and BDNF from muscle tissue during exercise and the possible relationship of these factors with improving muscle strength and performance, the present study aimed to investigate the effect of 12 weeks of strength training on muscle strength, body fat percentage, irisin, and BDNF in inactive middle-aged women.
Methods: In a semi-experimental study, 20 inactive middle-aged women (mean age 37.70 ± 5.91 years, weight 79.80 ± 5.82 kg) were selected and randomly assigned to two strength training groups (n = 10) and control groups (n = 10). The training group performed 12 weeks of strength training, three sessions per week at an intensity of 65 to 80% of maximum strength. Then, blood samples were taken using ELISA to measure irisin and BDNF. Independent t-test and Pearson correlation test were used to analyze the data. The significance level (P ≤ 0.05) was considered.
Results: Strength training significantly increased serum irisin concentration (P = 0.035) and serum BDNF concentration (P = 0.058) and also considerably decreased body fat percentage (P = 0.058) in middle-aged women. There was also a positive and significant relationship between lower body strength and serum irisin levels (P = 0.040). The Results from the Pearson correlation test indicate a significant positive relationship between BDNF and upper body strength (P = 0.038).
Conclusions: Based on the results of the present study, it seems that increased secretion of serum irisin and BDNF hormones is related to increased muscle strength following strength training in middle-aged individuals.