Background: Probiotics increase the defense power of immune system and accelerate the wound healing process by anti-inflammatory mechanisms at the wound site. The present study aimed at evaluating the effect of Lactobacillus casei oral supplementation on episiotomy wound healing among primiparous women. Methods: This triple-blind randomized clinical trial was performed on 74 primiparous women delivered in Alzahra Hospital, Tabriz, Iran. Participants with mediolateral episiotomy (incision length equal to and less than 5 cm) were randomly assigned to the probiotic and placebo groups. The probiotic group received Lactobacillus casei 431 with 1.5 * 10⁹ colony-forming unit /capsule once a day from the day after birth to 14 days. Wound healing as a primary outcome was measured by Redness, Edema, Ecchymosis, Discharge, Approximation and pain as a secondary outcome by the Visual Analogue Scale before discharge, 5 ± 1 and 15 ± 1 days after birth. The data were analyzed using independent t-test and repeated measures one way analysis of variance. Results: The mean (standard deviation: SD) score of wound healing in the probiotic group altered from 4.91(1.86) before discharge to 1.55 (0.99) during 5 ± 1 days after birth and reached to 0.95 (0.27) during 15 ± 1 days after birth. Further, the mean (SD) score of wound healing in the placebo group altered from 4.62 (1.99) before discharge to 2.80 (1.20) during 5 ± 1 days after birth and reached to 1.45(0.71) during 15 ± 1 days after birth (adjusted mean difference: -0.50, confidence interval 95%: -0.96 to -0.05, P = 0.03). Conclusion: Lactobacillus casei oral supplementation is effective in healing episiotomy wounds. It is suggested to evaluate the effect of topical use of Lactobacillus casei on episiotomy repair and pain in further studies. Trial registration: Iranian Registry of Clinical Trials (IRCT): IRCT20170506033834N7. Date of registration: 11/08/2021.

Women experienced traumatic childbirth talk about the lack of opportunity to express their worries and stresses. However, providing psychological support to reduce the long-term and severe consequences is essential. The present study aimed to determine the effect of supportive counseling on mother psychological reactions and mother-infant bonding following traumatic childbirth. This quasi experimental study was performed on 166 postpartum women with psychological birth trauma admitted to public hospitals in Arak, Iran. Postpartum bonding questionnaire was filled before hospital discharge. The women were randomly assigned into the intervention and control groups. The intervention group (n = 83) received individual supportive counseling for two in-person sessions before hospital discharge, and 10–15 days after delivery and a telephone consultation during 4–6 weeks after delivery. The data were collected using Edinburgh Postnatal Depression Scale, Post-Traumatic Stress Disorder checklist for DSM-5 (PCL-5), and the postpartum bonding questionnaire, after 2 months. The data were analyzed using SPSS₂₁ software and chi-square, t-test, and ANCOVA were used. The mean score of postpartum depression (PPD) symptoms in the intervention group was significantly lower than that in the control group (MD: −13.40, 95% CI: −10.66 to −16.15, P < 0.001). The severity of the PTSD symptoms in the intervention group was significantly lower than that in the control group (MD: −6.37, 95% CI: −3.55 to −9.18, P = 0.04). The mean (SD) of mother-infant bonding after controlling the effect of baseline score indicated a significant difference between the two groups (MD: −7.82, 95% CI: −6.53 to −9.11, P < 0.001). The supportive counseling seems to be effective in reducing PPD and PTSD symptoms, and improving postpartum bonding after traumatic childbirth. The use of group supportive counseling with other time intervals and long follow-up period is recommended. Further, other intervention approaches should be used for preventing the progression of psychological birth trauma toward PTSD.

Background: The aim of this study was to investigate the effect of kangaroo mother care (KMC) by mother and her surrogate on nutritional behavior and physiological function of preterm neonates.Method: This study was a randomized, controlled clinical trial conducted on 70 preterm infants admitted to the NICU. For the neonates of the intervention group, KMC was performed (by mother and surrogate) 3 times a day and the neonates of the control group received KMC by the mother 3 times a day for up to 4 days and 60 minutes each time. The primary outcome was to compare the effect of KMC by mother and surrogate on the feeding behavior measured by preterm infant breastfeeding behavior scale (PIBBS), and the secondary outcome was to compare the effect of KMC by mother and surrogate on physiological outcomes.Result: The score of the PIBBS in both groups increased significantly during 4 days, this difference was not significant between the groups. [Adjusted mean difference (95% Confidence interval), 0.66 (− 2.36 to 1.03),P = 0.438].Within the group, among the physiological functions, only O2 saturation had significantly increased during the study. This increase, however, was not statistically different between the two groups. [Adjusted mean difference (95% Confidence interval), 0.102 (− 0.68 to 0.88),P = 0.761].Conclusion: When the mother is unable to provide this type of care, it can be provided by the surrogate that is as effective as the mother in improving arterial oxygen saturation and the feeding behavior of the preterm neonates.Trial registration: IRCT20150424021917N10. Registered 22/04/ 2020

Introduction: Worry about cancer recurrence is identified as the most common psychological burdens experienced by cancer patients and survivors. The present study aimed to determine the predictors of worry about cancer recurrence among women with breast cancer.Materials and methods: This cross-sectional study was conducted on 166 women with breast cancer undergoing chemotherapy and radiotherapy, who referred to private and public oncology centers in Tabriz, Iran using the convenience sampling. Data collection tools were demographic and disease characteristics questionnaire, cancer worry scale, social support questionnaire, brief illness perception questionnaire, international physical activity questionnaire-short form, and The EORTC-in-patsat32. The data were analyzed using SPSS 25 software. Pearson correlation coefficient, independent t-test, ANOVA, and multivariate linear regression were used.Results: In the present study, the mean (standard deviation) of score of worry about cancer recurrence was 17.41 (7.88), ranging from 8–32. The results revealed that the type of surgery, illness perception, satisfaction with care, and place of treatment were the most important predictors of worry about cancer recurrence, which explained 44.3% of the variance.Conclusion: The enhancement of satisfaction with care and training coping strategies among individuals with high perceived severity of the illness contribute to the reduction of worry about cancer recurrence and adaptation to breast cancer.

Thods: The cross-sectional study was conducted on 190 women with breast cancer who were referred to oncology centers for chemotherapy and radiotherapy in Arak city, the central part of Iran. The participants were recruited utilizing convenience sampling method in a period from April to July 2018. Data were collected using demographic and disease characteristics questionnaires, QOL-Cancer30, QOL-Breast Cancer 23, Illness Perception Questionnaire, and Supportive Care Needs Survey – Short Form 34. Multivariate linear regression was used to analyze data. Results: The mean (standard deviation) score of cancer QOL was 57.1 (25.8). On the other hand, the mean (standard deviation) scores of the symptom and functional domains of breast cancer QOL were 43.3 (17.9) and 44.3 (21.7), respectively. Predictive variables for cancer QOL were spouse education, insurance coverage, type of surgery, type of treatment, supportive care needs, and illness perception. Predictive variables for the domain of symptoms of breast cancer QOL included spouse education, income, supportive care needs, and illness perception, while for the functional domain of breast cancer QOL, the predictive variables were the type of surgery, spouse age, supportive care needs, and illness perception. Conclusion: Fulfilling supportive care needs, helping to understand the curative nature of cancer, as well as empowering complementary health insurances are among intervenable variables to improve QOL among women with breast cancer....