Relationship between kind of delivery and dysmenorrhea

BackgroundThe term dysmenorrhea is currently used to refer to painful menstruation. The cause of primary dysmenorrhea has not been clearly elucidated. It has been said anecdotally that childbirth can ameliorate menstrual pain and some articles have proved a significant effect of childbirth on dysmenorrhea. Further investigations regarding the effects of delivery mode on dysmenorrhea has been rarely published. PurposeThis analytical retrospective study was conducted to identify relationship between the modes of delivery and dysmenorrhea and to compare its severity at early and late age of childbearing in women referring to selected hospitals affiliated to Tehran Medical University in 2006. Methods160 women between 36 and 44 were selected by convenience sampling method. An information form was used for data collection, validated and made reliable by content and test-retest methods respectively. ResultsFindings showed a significant decrease in dysmenorrheal pain at the time of study compared with early age of childbearing, before the first delivery. In women with dysmenorrhea, Caesarian rate was more than normal vaginal delivery and 46.2% of them had chosen Caesarian for their delivery.         ConclusionAccording to the results, delivery decreases dysmenorrheal pain. In addition, dysmenorrhea had been experienced more in women who were delivered by Caesarian. Therefore, the importance of normal vaginal delivery should be more emphasized in this regard. KeywordsDysmenorrhea, Delivery، Caesarian

Global burden, point sources, and outbreak management of healthcare-associated Burkholderia cepacia infections: an integrative review

Objective: To examine the global burden, associated point sources, and successful prevention and control measures for documented outbreaks of Burkholderia cepacia healthcare-associated infections (HAIs).Design: Integrative review.Methods: A review of all outbreaks of Burkholderia cepacia HAIs published in the peer-reviewed literature between January 1970 and October 2019 was conducted to identify the global burden, associated point sources, and successful prevention and control measures using the Guidelines for Outbreak Reports and Intervention Studies of Nosocomial Infections (ORION).Results: In total, we reviewed 125 documented outbreaks of Burkholderia cepacia-related HAIs worldwide. The reported B. cepacia HAIs for this period involved 3,287 patients. The point sources were identified in most outbreaks of B. cepacia HAIs (n = 93; 74.4%); they included medication vials, disinfectants, and antiseptics. Moreover, 95 of the outbreak reports (76%) described effective prevention and control measures, but only 33 reports indicated the use of a combination of environment-, patient- and staff-related measures. None of the outbreak reports used the ORION guidelines.Conclusions: Outbreaks of Burkholderia cepacia HAIs are an ongoing challenge. They are often associated with immunocompromised patients who acquire the infection from exposure to contaminated medications, products, and equipment. These outbreaks are not infrequent, and a range of infection prevention and control measures have been effective in arresting spread. The use of ORION guidelines for outbreak reporting would improve the quality of information and data to generate evidence for translation into practice

General practitioners’ knowledge, preparedness, and experiences of managing COVID-19 in Australia

BACKGROUND: COVID-19 has brought unprecedented demands to general practitioners (GPs) worldwide. We examined their knowledge, preparedness, and experiences managing COVID-19 in Australia. METHODS: A cross-sectional online survey of GPs members of the Royal Australian College of General Practitioners (RACGP) was conducted between June and September 2020. RESULTS: Out of 244 survey responses, a majority of GPs (76.6%) indicated having good knowledge of COVID-19, relying mostly on state/territory department of health (84.4%) and the RACGP (76.2%) websites to source up-to-date information. Most felt prepared to manage patients with COVID-19 (75.7%), yet over half reported not receiving training in the use of PPE. The majority were concerned about contracting SARS-CoV-2, more stressed than usual, and have heavier workloads. Their greatest challenges included scarcity of PPE, personal distress, and information overload. CONCLUSION: Access to PPE, training, accurate information, and preparedness are fundamental for the successful role of general practices during outbreaks