The Effect of Zumba Exercise on Reducing Menstrual Pain in Young Women with Primary Dysmenorrhea: A Randomized Controlled Trial

Study ObjectiveTo study the effectiveness of performing Zumba exercise on the severity and duration of pain in patients with primary dysmenorrhea.DesignRandomized controlled trial.SettingCairo University gynecology Hospital and Bahgat gym and fitness center.ParticipantsNinety-eight women diagnosed with primary dysmenorrhea.InterventionsStudy participants were divided randomly into 2 equal groups: group I included women who engaged in Zumba exercise for 60 minutes twice weekly for 8 weeks, and group II was a control group with no intervention.Main Outcome MeasuresThe primary outcome was the menstrual pain intensity measured using the visual analogue scale scores at 4 and 8 weeks after starting Zumba exercise. The secondary outcome was the difference in the duration of pain in both groups.ResultsBoth groups were homogeneous regarding the baseline demographic characteristics. The severity of primary dysmenorrhea at the beginning of the study was not significantly different between the 2 groups. Menstrual pain intensity was significantly decreased in the Zumba group after 4 and 8 weeks of Zumba compared with the control group (mean difference, −2.94 [95% confidence interval, −3.39 to −2.48] and −3.79 [95% confidence interval, −4.16 to −3.43], respectively; P = .001). Also, the duration of pain was shorter in the Zumba group compared with the control group at 8 weeks (4.92 ± 1.90 vs 9.10 ± 2.92 hours, respectively; P = .001).ConclusionThe Zumba intervention can reduce the severity and duration of menstrual pain thus suggesting that regularly performing Zumba might be a possible complementary treatment for primary dysmenorrhea.     

Assessment of Anxiety and Depression in Adolescents with Primary Dysmenorrhea: A Case-Control Study

Study ObjectiveTo examine the relationship between primary dysmenorrhea and symptoms of depression and anxiety among adolescent female students in Tbilisi, Georgia.DesignA case-control study.SettingTbilisi, Georgia.ParticipantsFour hundred twenty-four postmenarcheal girls aged 14-20 years (a subset of a larger study involving 2561 girls).MethodsThe data was gathered in 2011 by the use of a questionnaire prepared for the purpose of this study, completed anonymously. Menstrual pattern, depression and anxiety level were evaluated in both groups; continuous and categorical variables were compared by Pearson chi-square test. Depressive symptoms were determined by a self-reporting scale (Beck Depression Inventory); anxiety was determined using Taylor Manifest Anxiety Scale (TMAS) and Spielberger State-Trait Anxiety Inventory (STAI).Main Outcome MeasuresDifferences in mental health between two groups.ResultsPatients with primary dysmenorrhea (PD) had significantly higher scores of depression than the control subjects: moderate depression, 15.9% in PD patients vs 6.2% in control subjects and severe depression, 1.8% vs 0% (P < .003, LR 0.001). High anxiety (TMAS) was also more prevalent in adolescents with primary dysmenorrhea (44% vs 9.9%; P < .001, LR < 0.001). STAI scores were also significantly higher in these patients than in healthy women (68.9% vs 25.0%; P < .001, LR < 0.001).ConclusionPrimary dysmenorrhea is strongly linked with positive scores for depression and anxiety. Because of this association, attention should be given to effective mental health screening in these patients; psychological support may be necessary during their treatment and follow-up.     

原发性痛经患者外周血T淋巴细胞亚群的研究

目的 :探讨原发性痛经患者月经周期中外周血T淋巴细胞亚群的变化 ,分析原发性痛经患者的免疫状况。方法 :原发性痛经患者及正常对照组各 10例 ,分别于月经期、卵泡期、排卵期、黄体期取静脉血 ,应用流式细胞仪测定血浆CD4 + 、CD8+ 百分比值。结果 :原发性痛经患者月经期、卵泡期CD4 + 百分比值及CD4 /CD8的比值显著低于正常对照组 (P <0 0 5 ) ,原发性痛经患者整个月经周期CD8+ 百分值均明显高于正常对照组 (P <0 .0 5 )。结论 :原发性痛经患者存在免疫功能低下     

The Effect of Patient Positioning on Ureteral Efflux During Intraoperative Cystoscopy: A Randomized Controlled Trial

Study ObjectiveTo identify the relationship between patient position during surgery and time to confirmation of ureteral patency on cystoscopy.DesignRandomized controlled trial.SettingAcademic tertiary care medical center.Patients or ParticipantsA total of 91 adult women undergoing laparoscopic (either conventional or robotic) hysterectomy between February 2021 and February 2022 were randomized to intervention (n = 45) or control (n = 46). Exclusion criteria included known kidney disease or urinary tract anomaly, current ureteral stent, pregnancy, malignancy, and recognized intraoperative urinary tract injury.InterventionsSubjects in the control group were placed in a 0° supine position during cystoscopy. Subjects in the intervention group were placed in a 20° angle in reverse Trendelenburg (RT) position during cystoscopy.Measurements and Main ResultsThe primary outcome, time to confirmation of bilateral ureteral patency, was measured at the time the second ureteral jet was viewed during intraoperative cystoscopy. There was no significant difference in mean time to confirmation (66.5 seconds in supine vs 67 seconds in RT, p = .2) nor in total cystoscopy time (111 seconds in supine vs 104.5 seconds in RT, p = .39). There were no significant differences in need for alternative modalities to aid in ureteral efflux visualization, delayed diagnosis of ureteric injury, and operative time. RT position seemed to have reduced the time to confirmation for the small group of patients with longer confirmation time (>120 seconds).ConclusionRT position does not change time to confirmation of bilateral ureteral patency compared with supine position. However, there may be a benefit in position change if time to confirmation is >120 seconds.     

Controlled Clinical Trial Assessing the Effect of Laparoscopic Uterine Arterial Occlusion on Ovarian Reserve

Study ObjectiveTo assess the effect on ovarian reserve function after laparoscopic uterine artery occlusion (LUAO) compared with laparoscopic surgery supracervical hysterectomy (LSH) and laparoscopic myomectomy (LM).DesignProspective cohort study (Canadian Task Force classification II-1).SettingHospital with experience in gynecologic minimal access surgery.PatientsNinety patients with uterine myomas operated on from August through December 2007.InterventionNinety patients were divided into 3 groups of 30 patients each: the study group underwent LUAO and myomectomy (LUAO-M), control group 1 underwent LSH, and control group 2 underwent LM only.Measurements and Main ResultsBlood samples were collected before surgery and at 1, 3, and 6 months postoperatively. Concentrations of follicle-stimulating hormone (FSH), leuteinizing hormone (LH), and estradiol (EZ) were determined using an immunoassay, and serum inhibin B (INHB) concentration was evaluated using an enzyme-linked immunosorbent assay. No significant differences in preoperative hormone concentrations between the 3 groups were found (p >.05). In the LSH group, FSH, LH, and E2 concentrations were significantly increased, whereas the INHB concentration was significantly decreased at 1 month postoperatively (p <.05); after 3 months, only the INHB concentration was significantly decreased (p <.05). However, in the LOUA-M and LM groups, there were no significant differences between preoperative and postoperative hormone concentrations (p >.05). Serum concentrations of FSH, LH, and INHB in the LSH group were significantly different from those in the study group at 1 and 3 months postoperatively (p <.05); however, the differences in postoperative hormone concentrations between the study group and the LM group were not significant (p >.05).ConclusionAt short-term follow-up, no significant effect on ovarian reserve in patients with myoma who underwent LUAO was found.     

Effect of Ginger and Novafen on menstrual pain: A cross-over trial

Objective

Menstrual pain is a periodic pain which happens during the days of menses. The menstrual disturbances as a health problem among young girls affect not only reproductive, but also psychical health and quality of life. This study was done with the goal of comparing the effect of Ginger and Novafen on the menstrual pain.

The Effect of Fennel on Pain Quality,Symptoms, and Menstrual Duration in Primary Dysmenorrhea

Study ObjectivesTo assess the effectiveness of fennel on primary dysmenorrhea symptoms and menorrheal duration.DesignClinical trial study.SettingIslamic Azad University, Toyserkan.Participants80 female students were randomly divided in to two groups of intervention (n = 40) and control (n = 40).InterventionsThe intervention group was given one soft capsule Fennel (30 mg) every 4 hours, 3 days before menstruation till the 5th day and continued for 3 months. The control group received no medication.Main Outcome MeasuresThe severity of samples pain was graded using a visual analogue scale. 5 standard questionnaires include of Visual analog scale pain (VAS), McGill pain questionnaire, the range of stress about dysmenorrheal (VASA), Perceived stress scale, Well being scale were filled out in intervals of before, during and after fennel capsule uptake. Data were analyzed by SPSS 17 software. P < .05 was considered to be statistically significant.ResultsThe mean of nausea intensity and weakness decreased to 1.93, and 2.88 after 3 months, whereas they were 2.37, 6.65 in control group which indicated a significant difference. Reduce the duration of menstrual period, a significant difference was found after two and three months of use. Concern in terms of quality and feelings of well-being after 1 and 3 months, was observed significant difference compared with before using.ConclusionConsidering the safety of herbal medicines, this drug can use to relieve dysmenorrheal signs and menstrual duration.     

Anatomic Basis and Clinical Effect of Selective Dorsal Neurectomy for Patients with Lifelong Premature Ejaculation: A Randomized Controlled Trial

Introduction

Although guidelines from the American Urological Association and European Association of Urology do not consider surgical treatment for premature ejaculation (PE), the use of selective dorsal neurectomy (SDN) has increased for many years in Asian countries.

Effect of oral contraceptives containing estradiol and nomegestrol acetate or ethinyl-estradiol and chlormadinone acetate on primary dysmenorrhea

Abstract

Objective: To study the three cycles effect on primary dysmenorrhea of the monophasic 24/4 estradiol/nomegestrol acetate (E2/NOMAC) and of the 21/7 ethinyl-estradiol/chlormadinone acetate (EE/CMA) oral contraceptive. The tolerability and the effect of both preparations on metabolism and health-related quality of life were also evaluated.

Design: Prospective observational cohort study.

Setting: Tertiary gynecologic center for pelvic pain.

Patients: Subjects with primary dysmenorrhea requiring an oral contraceptive, who spontaneously selected either E2/NOMAC (n?=?20) or EE/CMA (n?=?20).

Main outcome measures: Visual Analogue Scale (VAS) score for dysmenorrhea, Short Form-36 questionnaire for health-related quality of life, lipoproteins and days of menstrual bleeding (withdrawal bleeding during oral contraceptive).

Results: Mean age and body mass index (BMI) were similar between the two groups. The final analysis was performed on 34 women, 15 in E2/NOMAC and 19 in EE/CMA group. Compliance with treatment was significantly higher with EE/CMA (100%) than E2/NOMAC (75%) (p?=?0.02). Both treatments significantly (p?<?0.0001) reduced VAS of primary dysmenorrhea, similarly (E2/NOMAC by a mean of 74.7%, EE/CMA by a mean of 78.4%; p?=?0.973). Only E2/NOMAC significantly increased SF-36 score (p?=?0.001), both in physical (p?=?0.001) and mental domains (p?=?0.004). The mean number of days of menstrual bleeding was significantly reduced in E2/NOMAC group (from 4.86?±?1.20?d to 2.64?±?1.59?d, p?=?0.0005 versus baseline, p?=?0.007 versus EE/CMA group). BMI did not vary in either group. E2/NOMAC did not change lipoproteins and apoproteins while EE/CMA increased total cholesterol (p?=?0.0114), HDL-cholesterol (p?=?0.0008), triglycerides (p?=?0.002), apoprotein-A1 (Apo-A1; p?=?0.0006) and apopoprotein-B (Apo-B; p?=?0.008), decreasing LDL/HDL ratio (p?=?0.024).

Conclusions: Both oral contraceptives reduced similarly primary dysmenorrhea, with E2/NOMAC also reducing withdrawal bleedings and being neutral on lipid metabolism.     

Perinatal Depression: A Randomized Controlled Trial of an Antenatal Education Intervention for Primiparas

Background: Depression can be an unexpected and distressing companion for a woman during the major life transition of becoming a mother for the first time. Researchers now demonstrate that approximately 50 percent of women will experience perinatal distress. Therefore, the etiology and management of perinatal depression is essential for a quality care of childbearing women. The objectives of this study were to develop an education intervention tailored to the information needs of primiparous women about perinatal depression, to deliver this intervention antenatally, and to conduct a randomized controlled trial to determine the effect of the antenatal education intervention in the reduction of postnatal depression. Method: A prospective, randomized controlled trial of the education intervention (n= 206) was conducted at three sites in Australia. The outcome of changes in mood state was measured by the Profile of Mood States questionnaire once antenatally (12–28 wk), and twice postnatally (8–12 and 16–24 wk); social support and demographic data were also collected. The education package was administered to the intervention group at the antenatal assessment of mood. Results: A significant and steady reduction in scores (overall and on the subscales) was observed over time for both groups that showed significant improvement in symptoms of depression. No difference was detected when comparing the intervention group with the control group. Additional multivariate regression analyses revealed no relevant influence of social support or demographic variables. Conclusions: Women in both the study and control groups were more depressed antenatally than postnatally. The finding that the education intervention made no difference challenges the two strongly held tenets of health education in childbearing women—that depression can be reduced through education and that antenatal education interventions can endure into the postnatal period.     

A Randomized Controlled Clinical Trial of Prenatal Oral Hygiene Education in Pregnancy-Associated Gingivitis

Introduction

Research shows there is a significant increase in gingival inflammation during pregnancy. This study was conducted to determine if an oral health intervention (OHI), including oral hygiene education delivered by nurse-led staff and an advanced over-the-counter (OTC) oral home care regimen, improved gingival inflammation in pregnant women with moderate-to-severe gingivitis compared with a standard oral hygiene control group.

Methods

This was a multicenter, randomized, controlled, single-masked, parallel group clinical trial conducted in obstetrics clinics of 2 medical centers. A total of 750 pregnant women between 8 and 24 weeks of pregnancy with at least 20 natural teeth and moderate-to-severe gingivitis (>30 intraoral bleeding sites) were enrolled. Participants were randomized to either the OHI group, which included oral hygiene instructions supplemented with an educational video and advanced OTC antibacterial/mechanical oral hygiene products, or the control group receiving oral hygiene instructions and standard products. Both groups received oral hygiene instructions from nurse-led staff. Experienced, masked examiners measured whole mouth gingival index (GI) and periodontal probing depths (PDs) at baseline and months 1, 2, and 3.

Results

Participants enrolled in this study presented with moderate-to-severe gingivitis at baseline. Both the OHI and control groups exhibited significant reductions in GI (P < .001) and PD (P < .03) from baseline that persisted throughout the study period. The OHI group exhibited modest, yet statistically greater, reductions in GI (P ≤ .044) compared with the control at all time points. The reduction in PD directionally favored the OHI group, but between-group differences were small (<0.03 mm) and not statistically significant (P > .18).

Discussion

Significant gingivitis was prevalent among participants in this study and identifies an opportunity to improve gingival health during pregnancy by providing oral health education during the course of prenatal care when coupled with an advanced OTC oral hygiene regimen.     

The Role of Ovarian Suspension in Endometriosis Surgery: A Randomized Controlled Trial

Study ObjectiveA very high percentage of patients with severe pelvic endometriosis develop adhesions after laparoscopic surgery. The objective of this trial was to evaluate the role of ovarian suspension performed during surgery for severe endometriosis on ovarian adhesions and postoperative pelvic pain.DesignA randomized controlled trial (Canadian Task Force classification I).SettingThe tertiary care University Hospital of Bologna, Bologna, Italy.PatientsEighty patients with ovarian and posterior deep infiltrating endometriosis were included in the study.InterventionsPatients underwent laparoscopic surgery for endometriosis and were randomized sequentially into 2 groups: transient ovarian suspension was performed in the treatment group (n = 40), whereas in the control group (n = 40) ovaries were left free in the pelvis. Symptom intensity (dysmenorrhea, chronic pelvic pain, dyspareunia, dyschezia, and dysuria) were ranked using a visual analog scale. Postsurgical ovarian adhesions were evaluated using transvaginal ultrasonographic scans performed by an ultrasound operator who was blinded to the details of the operative procedure and women's randomization allocation. Complications, lesion localization, endometrioma diameter, and surgery time were recorded.Measurements and Main ResultsAt follow-up, a significantly lower rate of ultrasound-detectable ovarian adhesions with the uterus and the bowel was observed in the treatment group, respectively (46.7% vs 77.3%, p = .003 and 26.7% vs 68.2%, p < .0005). Patients in the control group showed a higher percentage of fixed ovaries with moderate and severe adhesions than the treatment group, respectively (56.8% vs 28.9%, p = .003 and 20.5% vs 8.9%, p = .110). No differences between the 2 groups were found regarding complications and pelvic pain.ConclusionOvarian suspension seems to be an additional effective surgical procedure associated with an increased ovarian mobility in women treated for severe endometriosis. Moreover, it is feasible, safe, simple, and fast. Hence, it should be routinely used during laparoscopic surgery for endometriosis.     

The Effect of Psychosexual Education on Promoting Sexual Function,Genital Self-Image,and Sexual Distress among Women with Rokitansky Syndrome: A Randomized Controlled Clinical Trial

Study ObjectiveTo assess the effectiveness of psychosexual education on promoting sexual function and genital self-image and reducing sexual distress through e-learning among women with Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome.DesignRandomized controlled trial.SettingImam Khomeini Hospital “Pelvic Floor Clinic” in Tehran.ParticipantsThirty-eight 15- to 49-year-old women with MRKH syndrome who had undergone surgical or nonsurgical vaginal reconstruction techniques more than 6 months before the intervention were assigned to 2 parallel intervention and control groups of 19 each.InterventionsPsychosexual education was delivered through e-learning for the intervention group over an 8-week period, with no limitations of time and space. Sexual function, genital self-image, and sexual distress were evaluated at baseline, and at 4 and 8 weeks after the intervention.Main Outcome MeasuresThe data collection tools included the Persian version of the Female Sexual Function Index, Female Genital Self-Image Scale, and the Revised Female Sexual Distress Scale.ResultsThe between group mean differences of sexual function, genital self-image, and sexual distress after 4 weeks (?1.2 [95% CI, ?2.1 to ?0.1], P = .025; ?1.9 [95% CI, ?2.9 to ?0.9], P < .001; 4.2 [95% CI, 2.0-6.4], P < .001, respectively), as well as after 8 weeks (?1.8 [95% CI, ?3.1 to ?0.5], P = .009; ?3.0 [95% CI, ?4.5 to ?1.5], P < .001; 6.7, 95% CI, 3.9-9.6], P <0.001, respectively) after baseline were significant.ConclusionPsychosexual education improved sexual function and genital self-image and reduced sexual distress in women with MRKH syndrome. Therefore, using this approach, we can raise individuals’ sexual knowledge and skills and correct their sexual beliefs and attitudes.     

The Effects of Whirlpool Baths in Labor: A Randomized,Controlled Trial

ABSTRACT: Background : Showers and tubs in labor were not generally used in our center: When three whirlpool baths (Jacuzzis) were ordered as part of our renovations, a randomized, controlled trial was initiated to explore their effects on narcotic and epidural requirements. Methods : This study employed an intent-to-treat design, and the sample size was estimated to account for the fact that some women would be unable to use the tub. The experimental group of 393 women was offered the tub during labor and the control group of 392 women received conventional care. Results : No births occurred in the tub. The tub group required fewer pharmacologic agents than controls (66% vs 59%, p = 0.06), experienced fewer deliveries by forceps and vacuum (p = 0.019), and were more likely to have an intact perineum than the standard-care group (p = 0.019). Labor was longer for the tub group (p = 0.003), who coincidentally were more primiparous and in earlier labor on admission. No differences were noted in the low rates of maternal and newborn signs of infection in women with ruptured membranes. A subset of mothers expressed satisfaction with the tub experience and labor support. The cesarean rate among both groups was lower (8.9%) than our overall rate (16.6%) during the study period. Conclusions : Whirlpool baths in labor have positive effects on analgesia requirements, instrumentation rates, condition of the perineum, and personal satisfaction. Further study of the effects on labor length, pain, influence of labor support, and psychological outcomes is being planned.     

Effect of aromatherapy massage on pain in primary dysmenorrhea: A meta-analysis

ObjectiveThis meta-analysis investigates the effect of aromatherapy massage on pain in primary dysmenorrhea.MethodsRandomized controlled trials were searched by keywords in several databases (Pubmed, ISI Web of Sciences, and Google Scholar). Six randomized controlled trials that included 362 participants with primary dysmenorrhea, comparing abdominal aromatherapy massage (n = 184) with massage with placebo oils (n = 178), were analyzed in the meta-analysis. The change in the visual analogue scale (VAS) pain score from the first menstruation cycle to the second cycle at the first menstruation day was used as the primary outcome.ResultsAromatherapy massage with essential oils was superior to massage with placebo oils (standardized mean difference = −1.06 [95% CI: −1.55 to −0.55]).ConclusionAbdominal aromatherapy massage with essential oils is an effective complementary method to relieve pain in primary dysmenorrhea.     

Treatment of Prepubertal Labial Adhesions: A Randomized Controlled Trial

Study ObjectiveAlthough various treatment options have been proposed for the treatment of labial adhesions, there are currently no clearly outlined limits on the duration of topical therapy, amount of lateral traction to apply, and methods to decrease the recurrence. This clinical trial was undertaken to assess the need for estrogen for treatment of prepubertal labial adhesions.DesignRandomized, double-blinded, controlled trial.SettingPediatric and Adolescent Gynecology Clinic at a children's hospital in a metropolitan area.ParticipantsPrepubertal girls ages 3 months to 12 years with labial adhesions.InterventionsLateral traction with topical estrogen or topical emollient.Main Outcome MeasuresThe primary outcome was resolution of labial adhesions. The secondary outcome was the change in severity of labial adhesions over time between the 2 groups.ResultsForty-three girls were enrolled and 38 (88%) completed the study. The difference in complete resolution between the topical emollient group (19%) and the topical estrogen group (36%) was not statistically significant (P = .21). There was a statistically significant decrease in severity of labial adhesions over time, with the magnitude of improvement favoring the topical estrogen group.ConclusionAlthough labial adhesion severity decreased when treated with lateral traction and topical emollient or topical estrogen, the magnitude of the effect was significantly greater for topical estrogen.     

维生素E治疗原发性痛经的系统评价

目的:评价维生素E治疗原发性痛经的有效性及安全性.方法:电子检孝MEDLINE、EMBASE、Cochrane图书馆、CBM等6种数据库,手工检索8种中文杂志,并追查所有纳入研究的进行评价.同质的研究用RevMan4.2.8软件合并效应量,非同质的研究进行描述性分析.结果:共检索到相关文献247篇,评价后纳入3个随机对照试验(RCTs),共计388例患者.分析结果显示,维生素E与安慰剂相比,二者2个月时的月经期前和月经期疼痛缓解率,2个月、4个月时的VAS评分、疼痛持续时间、月经失血量及4个月中加服镇痛药物的人数比例的差异均有统计学意义.纳入研究中均未报告不良反应的发生情况.结论:维生素E在一定程度上能减轻原发性痛经的疼痛程度和持续时间,减少患者月经期的月经失血量,且使月经期加服镇痛药的人数比例下降.