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:: Volume 28, Issue 3 (4-2023) ::
__Armaghane Danesh__ 2023, 28(3): 292-306 Back to browse issues page
Evaluation the Effect of Teucrium Polium Plus Aloe Vera Gel on Episiotomy Wound Healing, Pain Intensity and Patient’s Satisfaction in Primiparous Women: A Single Blind Randomized Clinical Trial
M Azizi 1, SF Hekmatzadeh2 , H Sadeghi2 , T Bahmanzadeh3 , F Bazarganipour2
1- Fertility and Infertility Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran, , azizi.maryam@gmail.com
2- Medicinal Plants Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
3- Fertility and Infertility Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran,
Abstract:   (668 Views)
Background & aim: Considering the importance of pain reduction and recovery of episiotomy and faster return of mothers to daily activities and the lack of existing studies on the effect of the combined gel of Halepah-Aloe vera after episiotomy, therefore the purpose of the present study was to determine and evaluate the effect of Teucrium polium plus Aloe vera gel on episiotomy wound healing, pain intensity and patient’s satisfaction in primiparous women

Methods: The present randomized, blinded clinical trial study was conducted on 100 participants in Bandar Abbas Persian Gulf Hospital, Iran. Aloe vera gel combined or placebo gel was prescribed twice in the episiotomy wound site for 10 days in the intervention and control groups, respectively. The outcome variables included pain and wound healing with the Rida scale (the amount of redness, edema, ecchymosis, secretions and the proximity of the edges of the episiotomy wound), patients' satisfaction, and the evaluation of side effects. The collected data were analyzed using chi-square and t-test statistical tests.

Results: The results indicated that the two groups had a statistically significant difference in terms of the Rida score on the fourth and tenth day after delivery (p<0.05). The group of Helepe-Aloe vera combined gel had better wound healing time than placebo. Moreover, in the case of pain, there was a statistically significant lower score in the group of Helpeh-Aloe vera combined gel on the fourth day (5.80±1.34 vs. 6.79±1.42) and the tenth day (1.71±0.88 vs. 91 2.58±0.05) after delivery compared to placebo (p<0.05). The results of the study show that patient satisfaction on the fourth day (3.45±1.17 vs. 5.42±1.37) and the tenth day (1.33±0.57 vs. 2.50±1.21) after Delivery was significantly better compared to placebo (p<0.05).

Conclusion: The findings of this study indicated that the combined gel of Halpa-Aloe Vera improved episiotomy wound, better patient satisfaction and less pain intensity compared to the placebo.

 
Keywords: Halpe, aloe vera, episiotomy, satisfaction, pain
Full-Text [PDF 712 kb]   (183 Downloads)    
Type of Study: Research | Subject: Gynaecology
Received: 2022/11/7 | Accepted: 2023/05/6 | Published: 2023/05/6
References
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2. Marshall JE, Raynor MD, Nolte A. Myles textbook for midwives 3e african edition. E-Book: Myles Textbook for Midwives: Elsevier Health Sciences; 2016;715-756##
3. Lam KW, Wong HS, Pun TC. The practice of episiotomy in public hospitals in Hong Kong. Hong Kong Med J 2006; 12(2): 94-8. ##
4. Khajave K. Sedens episiotomy and complication episiotomy in primiparous women. J Ghom Univ Med Sci 2010; 3(2):1-4. ##
5. Dutta DC. Safe motherhood, epidemiology of obstetrics. Textbook of obstetrics. London: New Central Book Agency; 2010; 600-7. ##
6. Bick DE, Ismail KM, Macdonald S, Thomas P, Tohill S, Kettle C. How good are we at implementing evidence to support the management of birth related perineal trauma? A UK wide survey of midwifery practice. BMC Pregnancy Childbirth 2012; 12(1): 57. ## [DOI:10.1186/1471-2393-12-57] [PMID] []
7. Watanatitan J, Armarttasn S, Manusirivithaya S. Incidence and factors associated with postpartum perineal pain in primipara. Thai J Obstet Gynaecol 2009; 17(3): 139-44. ##
8. Azhari S, Aradmehr M, Rakhshandeh H, Tara F, Shakeri MT. The effects of chamomile cream on wound healing of episiotomy in primiparous women. Iran J Obstet Gynecol Infertil 2014; 17(93): 16-6. ##
9. Albers LL, Borders N. Minimizing genital tract trauma and related pain following spontaneous vaginal birth. J Midwifery Womens Health 2007; 52(3): 246-53. ## [DOI:10.1016/j.jmwh.2006.12.008] [PMID]
10. Andrews V, Thakar R, Sultan AH, Jones PW. Evaluation of postpartum perineal pain and dyspareunia--a prospective study. Eur J Obstet Gynecol Reprod Biol 2008; 137(2): 152-6. ## [DOI:10.1016/j.ejogrb.2007.06.005] [PMID]
11. Boyle M. Wound healing in midwifery. London: Radcliffe Publishing; 2006:1-6. ##
12. Karaçam Z, Ekmen H, Çalişır H, Şeker S. Prevalence of episiotomy in primiparas, related conditions, and effects of episiotomy on suture materials used, perineal pain, wound healing 3 weeks postpartum, in Turkey: a prospective follow-up study. Iran J Nurs Midwifery Res 2013; 18(3): 237-45. ##
13. East CE, Begg L, Henshall NE, Marchant PR, Wallace K. Local cooling for relieving pain from perineal trauma sustained during childbirth. Cochrane Database of Systematic Reviews 2012; 5: CD006304. ## [DOI:10.1002/14651858.CD006304.pub3]
14. Hall HG, McKenna LG, Griffiths DL. Midwives' support for complementary and alternative medicine: a literature review. Women and Birth 2012; 25(1): 4- 12. ## [DOI:10.1016/j.wombi.2010.12.005] [PMID]
15. Kamboj VP. Herbal medicine. Current Science 2000; 78(1):35- 9. ##
16. Tavakkoli Saberi M, Sedaghat, H. Medicinal plants. Gulshan Publications 1993; 23-27. ##
17. Ogalesyan GB, Galstyan AM, Mnatsakanyan VA, Shashkov AS, Agababyan PV. Phenylpropanoid glycosides of teucrium polium. Chem Nat Compd 1999; 27: 90-5. ##
18. Abrurjari T, Hadaib M, Cavrini V. Composition of the essential oil from Jordanian germander (Teucvium poliuml). Journal of Eessential Oil Research 2008; 18: 97-9. ## [DOI:10.1080/10412905.2006.9699398]
19. Ansari M, Alizadeh AM, Paknejad M, Khaniki M, Naeimi SM. Effects of teucrium polium honey on burn wound healing process. Journal of Babol University Medical Sciences 2009; 11: 7-12. ##
20. Hassan MM, Muntadi FJ, Al-badr AA. GLC mass spectrometry of teucrium polium oil. J Pharm Sci 1979; 68: 800-1. ## [DOI:10.1002/jps.2600680639] [PMID]
21. Capasso F, Cerri R, Morrica P, Senator F. Chemical composition and anti-inflammatory activity of an alcoholic extract of teucrium polium. Boll Soc Ital Biol Sper 1983; 59: 1639-43. ##
22. Tarig M, Ageel A, Al-Yahya MA, Mossa JS, al Said MS. Anti-inflammatory activity of teucrium polium. Int J Tissue React 1989; 11: 185-8. ##
23. Wassel GM, Ahemed SS. Chemical composition of the wild Egyptian plant teucrium polium-L. Pharmazie 1974; 29: 540-1. ##
24. Mohammady Rouzbahani A, Dolatian M, Jahedbozorgan T, Mojab F, Tajik M. Evaluation of the effect of Teucrium polium ointment on the episiotomy wound healing in primiparous women. Immunopathol Persa 2021; 7(2): e33. ## [DOI:10.34172/ipp.2021.33]
25. Chabane S, Boudjelal A, Keller M, Doubakh S, Potterat O. Teucrium polium - wound healing potential, toxicity and polyphenolic profile. South African Journal of Botany 2021; 137: 228-35. ## [DOI:10.1016/j.sajb.2020.10.017]
26. Fallah Huseini H, Abdolghaffari AH, Ahwazi M, Jasemi E, Yaghoobi M, Ziaee M. Topical application of teucrium polium can improve wound healing in diabetic Rats. The International Journal of Lower Extremity Wounds 2020; 19(2): 132-8. ## [DOI:10.1177/1534734619868629] [PMID]
27. Tanaka M, Misawa E, Ito Y, Habara N, Nomaguchi K, Yamada M, et al. Identificationof five phytosterols from Aloe Vera gel as antidiabetic compounds. Biol & Pharm Bull 2006; 29(7): 1418-22. ## [DOI:10.1248/bpb.29.1418] [PMID]
28. Mohammadi Gh. Aloevera, Institute of jungle research. Tehran.1994; 1-10. ##
29. Maan AA, Nazir A, Khan MK, Ahmad T, Zia R, Murid M, et al. The therapeutic properties and applications of Aloe vera: A review. Journal of Herbal Medicine 2018; 12: 1-10. ## [DOI:10.1016/j.hermed.2018.01.002]
30. Zhang J, Onakpoya IJ, Posadzki P, Eddouks M. The safety of herbal medicine: from prejudice to evidence. Evidence-Based Complementary and Alternative Medicine 2015; 2015: 316706. ## [DOI:10.1155/2015/316706] [PMID] []
31. Liang J, Cui L, Li J, Guan S, Zhang K, Li J. Aloe vera: a medicinal plant used in skin wound healing. Tissue Eng Part B Rev 2021; 27(5): 455-74. ## [DOI:10.1089/ten.teb.2020.0236] [PMID]
32. Yagi A, Hasegawa M, Ataka S. Possible efficacy of aloe vera gel to wound healing and pain relief: case reports of kampo medicine with aloe vera juice. Journal of Gastroenterology and Hepatology Research 2020; 9(5): 3298-302. ## [DOI:10.17554/j.issn.2224-3992.2020.09.959]
33. Tafazoli M, Saeedi R, Gholami robatsangi M, Mazloom R .Aloevera gel Vs. lanolin ointment in the treatment of nipple sore: a randomized clinical trial. Tehran University Medical Journal 2010; 67(10): 699-704. ##
34. Hekmatpou D, Mehrabi F, Rahzani K, Aminiyan A. The effect of aloe vera clinical trials on prevention and healing of skin wound: a systematic review. Iranian Journal of Medical Sciences 2019; 44(1): 1-9. ##
35. Donyavi T, Naieni KH, Nedjat S, Vahdaninia M, Najafi M, Montazeri A. Socioeconomic status and mortality after acute myocardial infarction: a study from Iran. International Journal for Equity in Health 2011; 10: 9. ## [DOI:10.1186/1475-9276-10-9] [PMID] []
36. Fadayevatan R, Alizadeh-Khoei M, Hessami-Azar ST, Sharifi F, Haghi M, Kaboudi B. Validity and Reliability of 11-face Faces Pain Scale in the Iranian Elderly Community with Chronic Pain. Indian J Palliat Care 2019; 25(1): 46-51. ##
37. Davidson N. REEDA: evaluating postpartum healing. J Nurse Midwifery 1974; 19(2): 6-8.
38. Pore YS. Effectiveness of moist heat and dry heat application on healing of episiotomy wound. Asian J Multidisciplinary Stud 2014; 2(7): 225-36. ##
39. Salih MA, Abdullah AN, Aziz S. Effect of hydroalcoholic extract of Teucrium polium on the process of wound healing in diabetic rats. Passer J 2020; 2(1): 37-45. ## [DOI:10.24271/psr.09]
40. Autore G, Capasso F, De Fusco R, Fasulo MP, Lembo M, Mascolo N, Menghini A. Antipyretic and antibacterial actions of Teucrium polium (L.). Pharmacol Res Commun 1984; 16: 21- 9. ## [DOI:10.1016/S0031-6989(84)80101-0] [PMID]
41. Su X, Liu X, Wang S, Li B, Pan T, Liu D, et al. Wound-healing promoting effect of total tannins from Entada phaseoloides (L.) Merr. Burns 2017; 43: 830-8. ## [DOI:10.1016/j.burns.2016.10.010] [PMID]
42. Sevindik E, Abacı ZT, Yamaner C, Ayvaz M. Determination of the chemical composition and antimicrobial activity of the essential oils of Teucrium polium and Achillea millefolium grown under North Anatolian ecological conditions. Biotechnol Biotechnol Equip 2016; 30: 375-80. ## [DOI:10.1080/13102818.2015.1131626]
43. Houshmand G, Goudarzi M, Forouzandeh H, Nazari A, Norolahi V. Evaluation of the Analgesic Effects of Teucrium Extract on Rats using the Formalin Test. J Babol Univ Med Sci 2015; 17(6): 33-9. ##
44. Shirmohamai Hesari Z, Zayeri F, Abadian K, Keshavarz Z, Akbari Nozari M. The effect of Teucrium polium capsule on pain duration of primary dysmenorrhea. The Iranian Journal of Obstetrics, Gynecology and Infertility 2018; 21(8): 66-74. ##
45. Sabzaligol M, Safari N, Baghcjeghi N, Latifi M, Koohestani HR, Bekhradi R, et al . The effect of Aloevera gel on prineal pain & wound healing after episiotomy. CMJA 2014; 4(2): 766-75. ##
46. Eshun K, He Q. Aloe vera: a valuable ingredient for the food, pharmaceutical and cosmetic industries-a review. Critical Reviews in Food Science and Nutrition 2004; 44(2): 91-6. ## [DOI:10.1080/10408690490424694] [PMID]
47. Moores J. Vitamin C: a wound healing perspective. British Journal of Community Nursing 2013; 18(Sup12): S6-11. ## [DOI:10.12968/bjcn.2013.18.Sup12.S6] [PMID]
48. Kashanian M, Lakeh MM, Ghasemi A, Noori S. Evaluation of the effect of vitamin E on pelvic pain reduction in women suffering from primary dysmenorrhea. The Journal of Reproductive Medicine 2013; 58(1-2): 34-8. ##
49. Hajhashemi V, Ghannadi A, Heidari AH. Anti-inflammatory and wound healing activities of Aloe littoralis in rats. Research in Pharmaceutical Sciences 2012; 7(2): 73. ##
50. Huston CJ. Outcomes measurement in healthcare: New imperatives for professional nursing practice. Nurs Case Manage 1999; 4: 188-95. ##
51. Wiechers DO, Wiechers DK. Demonstrating quality: Clinical outcome, functional status, patient satisfaction, value, and efficiency. Clin Rehabil Psychiatr Pract 1996; 7: 167-83. ## [DOI:10.1016/S1047-9651(18)30424-8]
52. Cunningham G, Leveno K, Dashe J, Hoffman B, Spong C, Casey B. Williams Obstetrics. 26th ed. New York: McGraw-Hill Education; 2022; 400-6.##
53. Marshall JE, Raynor MD, Nolte A. Myles textbook for midwives 3e african edition. E-Book: Myles Textbook for Midwives: Elsevier Health Sciences; 2016;715-756##
54. Lam KW, Wong HS, Pun TC. The practice of episiotomy in public hospitals in Hong Kong. Hong Kong Med J 2006; 12(2): 94-8. ##
55. Khajave K. Sedens episiotomy and complication episiotomy in primiparous women. J Ghom Univ Med Sci 2010; 3(2):1-4. ##
56. Dutta DC. Safe motherhood, epidemiology of obstetrics. Textbook of obstetrics. London: New Central Book Agency; 2010; 600-7. ##
57. Bick DE, Ismail KM, Macdonald S, Thomas P, Tohill S, Kettle C. How good are we at implementing evidence to support the management of birth related perineal trauma? A UK wide survey of midwifery practice. BMC Pregnancy Childbirth 2012; 12(1): 57. ## [DOI:10.1186/1471-2393-12-57] [PMID] []
58. Watanatitan J, Armarttasn S, Manusirivithaya S. Incidence and factors associated with postpartum perineal pain in primipara. Thai J Obstet Gynaecol 2009; 17(3): 139-44. ##
59. Azhari S, Aradmehr M, Rakhshandeh H, Tara F, Shakeri MT. The effects of chamomile cream on wound healing of episiotomy in primiparous women. Iran J Obstet Gynecol Infertil 2014; 17(93): 16-6. ##
60. Albers LL, Borders N. Minimizing genital tract trauma and related pain following spontaneous vaginal birth. J Midwifery Womens Health 2007; 52(3): 246-53. ## [DOI:10.1016/j.jmwh.2006.12.008] [PMID]
61. Andrews V, Thakar R, Sultan AH, Jones PW. Evaluation of postpartum perineal pain and dyspareunia--a prospective study. Eur J Obstet Gynecol Reprod Biol 2008; 137(2): 152-6. ## [DOI:10.1016/j.ejogrb.2007.06.005] [PMID]
62. Boyle M. Wound healing in midwifery. London: Radcliffe Publishing; 2006:1-6. ##
63. Karaçam Z, Ekmen H, Çalişır H, Şeker S. Prevalence of episiotomy in primiparas, related conditions, and effects of episiotomy on suture materials used, perineal pain, wound healing 3 weeks postpartum, in Turkey: a prospective follow-up study. Iran J Nurs Midwifery Res 2013; 18(3): 237-45. ##
64. East CE, Begg L, Henshall NE, Marchant PR, Wallace K. Local cooling for relieving pain from perineal trauma sustained during childbirth. Cochrane Database of Systematic Reviews 2012; 5: CD006304. ## [DOI:10.1002/14651858.CD006304.pub3]
65. Hall HG, McKenna LG, Griffiths DL. Midwives' support for complementary and alternative medicine: a literature review. Women and Birth 2012; 25(1): 4- 12. ## [DOI:10.1016/j.wombi.2010.12.005] [PMID]
66. Kamboj VP. Herbal medicine. Current Science 2000; 78(1):35- 9. ##
67. Tavakkoli Saberi M, Sedaghat, H. Medicinal plants. Gulshan Publications 1993; 23-27. ##
68. Ogalesyan GB, Galstyan AM, Mnatsakanyan VA, Shashkov AS, Agababyan PV. Phenylpropanoid glycosides of teucrium polium. Chem Nat Compd 1999; 27: 90-5. ##
69. Abrurjari T, Hadaib M, Cavrini V. Composition of the essential oil from Jordanian germander (Teucvium poliuml). Journal of Eessential Oil Research 2008; 18: 97-9. ## [DOI:10.1080/10412905.2006.9699398]
70. Ansari M, Alizadeh AM, Paknejad M, Khaniki M, Naeimi SM. Effects of teucrium polium honey on burn wound healing process. Journal of Babol University Medical Sciences 2009; 11: 7-12. ##
71. Hassan MM, Muntadi FJ, Al-badr AA. GLC mass spectrometry of teucrium polium oil. J Pharm Sci 1979; 68: 800-1. ## [DOI:10.1002/jps.2600680639] [PMID]
72. Capasso F, Cerri R, Morrica P, Senator F. Chemical composition and anti-inflammatory activity of an alcoholic extract of teucrium polium. Boll Soc Ital Biol Sper 1983; 59: 1639-43. ##
73. Tarig M, Ageel A, Al-Yahya MA, Mossa JS, al Said MS. Anti-inflammatory activity of teucrium polium. Int J Tissue React 1989; 11: 185-8. ##
74. Wassel GM, Ahemed SS. Chemical composition of the wild Egyptian plant teucrium polium-L. Pharmazie 1974; 29: 540-1. ##
75. Mohammady Rouzbahani A, Dolatian M, Jahedbozorgan T, Mojab F, Tajik M. Evaluation of the effect of Teucrium polium ointment on the episiotomy wound healing in primiparous women. Immunopathol Persa 2021; 7(2): e33. ## [DOI:10.34172/ipp.2021.33]
76. Chabane S, Boudjelal A, Keller M, Doubakh S, Potterat O. Teucrium polium - wound healing potential, toxicity and polyphenolic profile. South African Journal of Botany 2021; 137: 228-35. ## [DOI:10.1016/j.sajb.2020.10.017]
77. Fallah Huseini H, Abdolghaffari AH, Ahwazi M, Jasemi E, Yaghoobi M, Ziaee M. Topical application of teucrium polium can improve wound healing in diabetic Rats. The International Journal of Lower Extremity Wounds 2020; 19(2): 132-8. ## [DOI:10.1177/1534734619868629] [PMID]
78. Tanaka M, Misawa E, Ito Y, Habara N, Nomaguchi K, Yamada M, et al. Identificationof five phytosterols from Aloe Vera gel as antidiabetic compounds. Biol & Pharm Bull 2006; 29(7): 1418-22. ## [DOI:10.1248/bpb.29.1418] [PMID]
79. Mohammadi Gh. Aloevera, Institute of jungle research. Tehran.1994; 1-10. ##
80. Maan AA, Nazir A, Khan MK, Ahmad T, Zia R, Murid M, et al. The therapeutic properties and applications of Aloe vera: A review. Journal of Herbal Medicine 2018; 12: 1-10. ## [DOI:10.1016/j.hermed.2018.01.002]
81. Zhang J, Onakpoya IJ, Posadzki P, Eddouks M. The safety of herbal medicine: from prejudice to evidence. Evidence-Based Complementary and Alternative Medicine 2015; 2015: 316706. ## [DOI:10.1155/2015/316706] [PMID] []
82. Liang J, Cui L, Li J, Guan S, Zhang K, Li J. Aloe vera: a medicinal plant used in skin wound healing. Tissue Eng Part B Rev 2021; 27(5): 455-74. ## [DOI:10.1089/ten.teb.2020.0236] [PMID]
83. Yagi A, Hasegawa M, Ataka S. Possible efficacy of aloe vera gel to wound healing and pain relief: case reports of kampo medicine with aloe vera juice. Journal of Gastroenterology and Hepatology Research 2020; 9(5): 3298-302. ## [DOI:10.17554/j.issn.2224-3992.2020.09.959]
84. Tafazoli M, Saeedi R, Gholami robatsangi M, Mazloom R .Aloevera gel Vs. lanolin ointment in the treatment of nipple sore: a randomized clinical trial. Tehran University Medical Journal 2010; 67(10): 699-704. ##
85. Hekmatpou D, Mehrabi F, Rahzani K, Aminiyan A. The effect of aloe vera clinical trials on prevention and healing of skin wound: a systematic review. Iranian Journal of Medical Sciences 2019; 44(1): 1-9. ##
86. Donyavi T, Naieni KH, Nedjat S, Vahdaninia M, Najafi M, Montazeri A. Socioeconomic status and mortality after acute myocardial infarction: a study from Iran. International Journal for Equity in Health 2011; 10: 9. ## [DOI:10.1186/1475-9276-10-9] [PMID] []
87. Fadayevatan R, Alizadeh-Khoei M, Hessami-Azar ST, Sharifi F, Haghi M, Kaboudi B. Validity and Reliability of 11-face Faces Pain Scale in the Iranian Elderly Community with Chronic Pain. Indian J Palliat Care 2019; 25(1): 46-51. ##
88. Davidson N. REEDA: evaluating postpartum healing. J Nurse Midwifery 1974; 19(2): 6-8.
89. Pore YS. Effectiveness of moist heat and dry heat application on healing of episiotomy wound. Asian J Multidisciplinary Stud 2014; 2(7): 225-36. ##
90. Salih MA, Abdullah AN, Aziz S. Effect of hydroalcoholic extract of Teucrium polium on the process of wound healing in diabetic rats. Passer J 2020; 2(1): 37-45. ## [DOI:10.24271/psr.09]
91. Autore G, Capasso F, De Fusco R, Fasulo MP, Lembo M, Mascolo N, Menghini A. Antipyretic and antibacterial actions of Teucrium polium (L.). Pharmacol Res Commun 1984; 16: 21- 9. ## [DOI:10.1016/S0031-6989(84)80101-0] [PMID]
92. Su X, Liu X, Wang S, Li B, Pan T, Liu D, et al. Wound-healing promoting effect of total tannins from Entada phaseoloides (L.) Merr. Burns 2017; 43: 830-8. ## [DOI:10.1016/j.burns.2016.10.010] [PMID]
93. Sevindik E, Abacı ZT, Yamaner C, Ayvaz M. Determination of the chemical composition and antimicrobial activity of the essential oils of Teucrium polium and Achillea millefolium grown under North Anatolian ecological conditions. Biotechnol Biotechnol Equip 2016; 30: 375-80. ## [DOI:10.1080/13102818.2015.1131626]
94. Houshmand G, Goudarzi M, Forouzandeh H, Nazari A, Norolahi V. Evaluation of the Analgesic Effects of Teucrium Extract on Rats using the Formalin Test. J Babol Univ Med Sci 2015; 17(6): 33-9. ##
95. Shirmohamai Hesari Z, Zayeri F, Abadian K, Keshavarz Z, Akbari Nozari M. The effect of Teucrium polium capsule on pain duration of primary dysmenorrhea. The Iranian Journal of Obstetrics, Gynecology and Infertility 2018; 21(8): 66-74. ##
96. Sabzaligol M, Safari N, Baghcjeghi N, Latifi M, Koohestani HR, Bekhradi R, et al . The effect of Aloevera gel on prineal pain & wound healing after episiotomy. CMJA 2014; 4(2): 766-75. ##
97. Eshun K, He Q. Aloe vera: a valuable ingredient for the food, pharmaceutical and cosmetic industries-a review. Critical Reviews in Food Science and Nutrition 2004; 44(2): 91-6. ## [DOI:10.1080/10408690490424694] [PMID]
98. Moores J. Vitamin C: a wound healing perspective. British Journal of Community Nursing 2013; 18(Sup12): S6-11. ## [DOI:10.12968/bjcn.2013.18.Sup12.S6] [PMID]
99. Kashanian M, Lakeh MM, Ghasemi A, Noori S. Evaluation of the effect of vitamin E on pelvic pain reduction in women suffering from primary dysmenorrhea. The Journal of Reproductive Medicine 2013; 58(1-2): 34-8. ##
100. Hajhashemi V, Ghannadi A, Heidari AH. Anti-inflammatory and wound healing activities of Aloe littoralis in rats. Research in Pharmaceutical Sciences 2012; 7(2): 73. ##
101. Huston CJ. Outcomes measurement in healthcare: New imperatives for professional nursing practice. Nurs Case Manage 1999; 4: 188-95. ##
102. Wiechers DO, Wiechers DK. Demonstrating quality: Clinical outcome, functional status, patient satisfaction, value, and efficiency. Clin Rehabil Psychiatr Pract 1996; 7: 167-83. ## [DOI:10.1016/S1047-9651(18)30424-8]
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Azizi M, Hekmatzadeh S, Sadeghi H, Bahmanzadeh T, Bazarganipour F. Evaluation the Effect of Teucrium Polium Plus Aloe Vera Gel on Episiotomy Wound Healing, Pain Intensity and Patient’s Satisfaction in Primiparous Women: A Single Blind Randomized Clinical Trial. armaghanj 2023; 28 (3) :292-306
URL: http://armaghanj.yums.ac.ir/article-1-3398-en.html


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