Publications by authors named "Neda Hashemi"

21 Publications

  • Page 1 of 1

Maternal and Fetal Outcomes of Pregnant Women Infected with Coronavirus Based on Tracking the Results of 90-Days Data in Hazrat -E- Rasoul Akram Hospital, Iran University of Medical Sciences.

Bull Emerg Trauma 2021 Jul;9(3):145-150

Endometriosis Research Center, Iran University of Medical Sciences (IUMS), Tehran, Iran.

Objective: To evaluate the maternal and fetal outcomes of COVID-19 up to three months after the delivery in pregnant women.

Methods: This case series study was conducted on all pregnant women with COVID-19 hospitalized in Hazrat -E- Rasoul Akram Hospital, Tehran, Iran from March 8, 2020 to December 28, 2020. Data were included maternal age and gestational age (GA) which presenting signs and symptoms were collected at hospital admission. To confirm COVID-19 diagnosis, high-resolution computed tomography (HRCT) or reverse transcription-polymerase chain reaction (RT-PCR) tests were conducted. Both the mothers and the newborns were followed up to three months after delivery.

Results: Fourteen pregnant women with the median age of 31.5 were enrolled. HRCT was done in twelve mothers (85.7%), and eleven mothers (78.6%) were evaluated via RT-PCR; four of them (36.36%) were positive. Two mothers (14.28%) were admitted to ICU. The cesarean section (C/S) was done following fetal distress in only three mothers due to their concerns of vertical transmission. Two mothers were admitted to the intensive care unit (ICU), and one of them died of pneumomediastinum. Fortunately, no neonatal death was reported three months after the delivery.

Conclusion: COVID-19 affects mothers more in the last trimester of the pregnancy. Although no fetal death was reported in the recent study, physicians should closely monitor pregnant women to reduce the adverse event .
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.30476/BEAT.2021.90434.1254DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8286654PMC
July 2021

Babu and Magon uterine closure technique during cesarean section: A randomized double-blind trial.

J Obstet Gynaecol Res 2021 Sep 15;47(9):3186-3195. Epub 2021 Jun 15.

Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel, Germany.

Aim: We compared the effectiveness of the Babu and Magon uterine closure technique and unlocked double-layer uterine closure on the integrity and thickness of the uterine scar.

Methods: A randomized double-blind trial was performed at Hazrat-e Rasoul -e-Akram Hospital, Tehran, Iran, from March 2018 to December 2019, in 72 pregnant women who were candidates for cesarean section for the first time. Women were randomly assigned to the Babu and Magon uterine closure technique (intervention group, n = 34) or double-layer closure of the uterine incision (control group, n = 38). The primary outcome of the study was the frequency of myometrial defects at the site of the scar (niche), and a large niche. Secondary outcomes, including the time taken for uterine closure and postpartum hemorrhage (early and late), were compared between groups.

Results: Adjacent myometrium thickness (AMT) between the two groups was not statistically significant. A niche was reported in 23.5% (8/34) and 50% (19/38) of women in the intervention and controls, respectively (p = 0.02). A large niche was reported in 2.9% (1/34) and 23.7% (9/38) of women in the intervention and controls, respectively (p < 0.01). The duration of uterine closure was not statistically significant between the two groups. Hemoglobin levels did not differ significantly between groups during the first 24 h post-surgery.

Conclusion: The results of the study showed that the technique of uterine closure is one of the main potential determinants of myometrial healing. The Babu and Magon uterine closure technique seems to lead to tissue alignment during suturing and consequently cause better myometrial healing, although this issue calls for well-founded longer studies of appropriate design.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jog.14889DOI Listing
September 2021

The Impact of COVID-19 Pandemic on Stress and Anxiety of Non-infected Pregnant Mothers.

J Reprod Infertil 2021 Apr-Jun;22(2):125-132

Endometriosis Research Center, Iran University of Medical Sciences (IUMS), Tehran, Iran.

Background: The newly emerging COVID-19 has caused severe anxiety around the world and it is infecting more people each day since there is no preventive measure or definite therapy for the diseases. The present study aimed to evaluate its effect on anxiety and stress of pregnant mothers during perinatal care.

Methods: Three-hundred pregnant mothers without COVID-19 infection who were referred to the hospitals affiliated to Iran University of Medical Sciences for delivery during April 2020, based on negative clinical symptoms and the results of polymerase chain reaction (rt-PCR) for COVID-19, were recruited by census method and asked to complete the Persian version of the perceived stress scale (PSS); participants views about their anxiety level and the role of COVID-19 as the source of their stress and worries were recorded. Women who refused to continue the study were excluded. The frequency of variables and mean scores were calculated using SPSS v. 21.

Results: Mean age of mothers was 30.20±16.19 years; 31.3% were primigravida and mean gestational age was 38.00±4.14 weeks. Moreover, 16.3% asked for earlier pregnancy termination and 39% requested Cesarean section (C/S). Assessing the mothers' anxiety revealed a high/very high level of anxiety in 51.3%. The majority felt worried and frustrated because of COVID-19 (86.4%). Social media had a great impact on the level of stress among these mothers (60.3%).

Conclusion: COVID-19 pandemic is an important source for the increased anxiety and stress among healthy pregnant mothers.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.18502/jri.v22i2.5801DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8143014PMC
May 2021

Woman with Pregnancy and Lactation-Associated Osteoporosis (PLO).

Case Rep Obstet Gynecol 2020 12;2020:8836583. Epub 2020 Nov 12.

Department of internal medicine, Shahid Mostafa Khomeini Hospital, Ilam University of Medical Sciences, Ilam, Iran.

Osteoporosis is a disease known to reduce bone density and to damage bone microarchitecture leading to increased fracture risk. Osteoporosis is one of the most common diseases among the middle aged and elderly people that impose high costs on the community. So far, despite rare cases of pregnancy and lactation-associated osteoporosis (PLO) reported in Iran, it can be treated with accurate diagnosis. . A 24-year-old woman was referred to the outpatient rheumatologic clinic after the cesarean section during the first pregnancy with severe back pain. In the thoracolumbar radiographs, a loss of vertebral height in the T11 to L5 vertebra was recognized. Other complaints were abdominal pain and anemia. In order to evaluate the gastrointestinal disease and celiac, the patient underwent gastrointestinal and hematologic workup. Ultimately, secondary causes of the osteoporosis were excluded. Based on the patient's clinical course, imaging finding, and exclusion of other causes of osteoporosis, the patient was diagnosed with PLO. . Clinicians should be aware of PLO as rare complication of pregnancy. The situation should be particularly considered in females offering from new onset back pain in the third trimester of pregnancy or breastfeeding period.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1155/2020/8836583DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7676963PMC
November 2020

Gender Differences in the Association between Positive Drinking Attitudes and Alcohol-Related Problems. The WIRUS Study.

Int J Environ Res Public Health 2020 08 16;17(16). Epub 2020 Aug 16.

Department of Public Health, Faculty of Health Sciences, University of Stavanger, 4036 Stavanger, Norway.

Alcohol consumption is deeply integrated in people's social- and work lives and, thus, constitutes a serious public health challenge. Attitudes toward drinking stand out as important predictors of drinking, but have to date been sparsely studied in employee populations. This study explores the association of employees' attitudes toward drinking with their alcohol-related problems, and whether this association is moderated by gender and employment sector. Cross-sectional data were collected from a heterogeneous sample of employees ( = 4094) at 19 Norwegian companies. Drinking attitudes were assessed using the Drinking Norms Scale. The AUDIT (Alcohol Use Disorders Identification Test) scale was then used to assess any alcohol-related problems. Data were analyzed using chi-square tests, analysis of covariance (ANCOVA), and multiple logistic regression. Employees with predominantly positive drinking attitudes were almost three times as likely to report alcohol-related problems compared to employees with more negative drinking attitudes (OR = 2.75; 95% CI: 2.00-3.76). Gender moderated the association between positive drinking attitudes and alcohol-related problems (OR = 3.30; 95% CI: 2.10-5.21). The association was stronger in women (OR = 5.21; 95% CI: 3.34-8.15) than in men (OR = 3.10; 95% CI: 2.11-4.55). Employment sector did not moderate the association between drinking attitudes and alcohol-related problems. Employee attitudes toward alcohol should be monitored to better enable early workplace health promotion interventions targeting alcohol problems. These interventions might need to be gender-specific.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ijerph17165949DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7460403PMC
August 2020

Perceived discrimination and subjective well-being among Middle Eastern migrants in Australia: The moderating role of perceived social support.

Int J Soc Psychiatry 2021 Mar 8;67(2):110-119. Epub 2020 Jul 8.

School of Medicine, Griffith University, Gold Coast, QLD, Australia.

Background: Middle Eastern (ME) migrants are vulnerable to developing mental health problems due to pre-migration and post-migration traumas and stresses. The evidence on the subjective well-being of ME migrants and its contributing factors is limited and inconclusive.

Objectives: The aim of this study is to examine the moderating role of perceived social support in the association between perceived discrimination and subjective well-being, after controlling for socio-demographic factors.

Method(s): This cross-sectional survey study was conducted in Queensland, Australia. A total of 382 first-generation young adult ME migrants, aged between 20 to 39 years, completed a self-administered questionnaire. To analyse data, a series of three hierarchical multiple regression (HMR) analyses were conducted, one for each of the subjective well-being components (i.e., positive affect, negative affect, and satisfaction with life). The interaction between perceived social support and perceived discrimination for the prediction of subjective well-being components was further explored using simple slope analysis.

Results: Gender was found to be a significant predictor of positive and negative affect. Education was found to predict satisfaction with life, but not positive and negative affect. Married migrants were found to have significantly higher life satisfaction, positive affect and lower negative affect. Perceived social support had a moderating role in the association between perceived discrimination and subjective well-being.

Conclusion: Considering the buffering role of perceived social support against the adverse effects of perceived discrimination on subjective well-being, organizations and individuals working with ME migrants should acknowledge the significance of social support and improve their capacity to deliver effective and appropriate social support services to migrants experiencing discrimination.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/0020764020940740DOI Listing
March 2021

Pharmacist-Driven Oral Oncolytic Medication Education and Consent.

JCO Oncol Pract 2020 10 27;16(10):e1209-e1215. Epub 2020 May 27.

Section of Hematology and Oncology, Division of Internal Medicine, University of New Mexico Comprehensive Cancer Center, Albuquerque, NM.

Purpose: The numbers and types of oral oncolytics in oncology are expanding rapidly. Oral oncolytics have serious adverse effects, and pharmacist-driven patient education has the potential to reduce adverse events. The University of New Mexico Comprehensive Cancer Center (UNM CCC) initiated a patient education and consent process for oral oncolytics in our minority, rural, and economically disadvantaged population.

Patients And Methods: The UNM CCC initiated a pharmacist-driven education and consent process from August 2016 to October 2018. The process metric measured via statistical process control charts was the percentage of patients receiving oral oncolytic therapy who were educated and consented. The balancing metric was time for benefit investigation. The intervention was pharmacy team members providing standardized education for and obtaining consent from each patient, supported by electronic medical record orders, physician education, pharmacy notifications, and hospital discharge planning.

Results: The initial monthly education and consent rate was 17.9%, followed by 45.5% the subsequent month. This quickly grew to an average of 87.0% (95% CI, 81.5% to 92.4%) for the subsequent 15 months in which control was achieved. Additional changes increased the education rate to 95.7% (95% CI, 93.4% to 98.1%). These 2 periods were statistically different ( = .0025). There was no change in time for benefit investigation (5.60 5.52 days; = .75).

Conclusion: A pharmacist-driven program for education and consent upon initiation of oral oncolytics is possible and can successfully educate a majority of patients. Future directions will include ensuring patient adherence and educating patients who fill oral oncolytic prescriptions outside UNM CCC.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1200/JOP.19.00418DOI Listing
October 2020

Amyotrophic onset in GCH1 dopa-responsive dystonia.

Iran J Neurol 2019 Oct;18(4):181-183

Department Obstetrics and Gynecology, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7036049PMC
October 2019

The effect of vaginal progesterone on Doppler findings in increased uterine artery resistance.

J Matern Fetal Neonatal Med 2021 Aug 30;34(16):2630-2633. Epub 2019 Oct 30.

Endometriosis Research Center, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.

Objective: The present study aimed to evaluate the effect of vaginal progesterone on Doppler finding in increased uterine artery resistance compared with aspirin.

Materials And Methods: This study is a double-blind randomized clinical trial that was conducted on 140 pregnant women with increased uterine artery resistance who were referred to the Shariati hospital (Tehran, Iran) in 2017-2018. Patients were randomized to 1 of the 3 treatment groups - group A: tablet aspirin 80 mg; group B: vaginal suppository progesterone; and group C: control group without any intervention. Low-risk pregnant women at the gestational age of 16-20 weeks, were assessed by the uterine artery Doppler. In the presence of increased resistance of the uterine artery, patients were randomly assigned to one of the three above mentioned groups.

Results: The results of paired -tests for right uterine artery pulsatility index (RUA.PI), right uterine artery resistance index (RUA.RI), left uterine artery PI (LUA.PI), and left uterine artery RI (LUA.RI) before and after of intervention in the three groups were statistically significant. Also, the one-way analysis of variance (ANOVA) results for comparison between three groups showed that before the intervention only means of RUA.PI has a significant difference between three groups ( = .025), but means of all variables after intervention shows a significant difference ( < .001).

Conclusion: The findings showed that the use of vaginal progesterone suppressed the resistance of uterine artery compared to aspirin.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/14767058.2019.1670794DOI Listing
August 2021

Association between alcohol consumption and impaired work performance (presenteeism): a systematic review.

BMJ Open 2019 07 16;9(7):e029184. Epub 2019 Jul 16.

Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway.

Objectives: The aim of this review was to explore the notion of alcohol-related presenteeism; that is, whether evidence in the research literature supports an association between employee alcohol consumption and impaired work performance.

Design: Systematic review of observational studies.

Data Sources: MEDLINE, Web of Science, PsycINFO, CINAHL, AMED, Embase and Swemed+ were searched through October 2018. Reference lists in included studies were hand searched for potential relevant studies.

Eligibility Criteria: We included observational studies, published 1990 or later as full-text empirical articles in peer-reviewed journals in English or a Scandinavian language, containing one or more statistical tests regarding a relationship between a measure of alcohol consumption and a measure of work performance.

Data Extraction And Synthesis: Two independent reviewers extracted data. Tested associations between alcohol consumption and work performance within the included studies were quality assessed and analysed with frequency tables, cross-tabulations and χ tests of independence.

Results: Twenty-six studies were included, containing 132 tested associations. The vast majority of associations (77%) indicated that higher levels of alcohol consumption were associated with higher levels of impaired work performance, and these positive associations were considerably more likely than negative associations to be statistically significant (OR=14.00, 0.37, p<0.001). Alcohol exposure measured by hangover episodes and composite instruments were over-represented among significant positive associations of moderate and high quality (15 of 17 associations). Overall, 61% of the associations were characterised by low quality.

Conclusions: Evidence does provide some support for the notion of alcohol-related presenteeism. However, due to low research quality and lack of longitudinal designs, evidence should be characterised as somewhat inconclusive. More robust and less heterogeneous research is warranted. This review, however, does provide support for targeting alcohol consumption within the frame of workplace interventions aimed at improving employee health and productivity.

Prospero Registration Number: CRD42017059620.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2019-029184DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6661906PMC
July 2019

Mesenteric ischemia in pregnant woman: a case report.

J Obstet Gynaecol 2019 Oct 4;39(7):1012-1014. Epub 2019 Jun 4.

Endometriosis Research Center Iran University of Medical Sciences , Tehran , Iran.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/01443615.2019.1572077DOI Listing
October 2019

Development of a scoring system for prediction of placenta accreta and determine the accuracy of its results.

J Matern Fetal Neonatal Med 2020 Jun 4;33(11):1824-1830. Epub 2018 Nov 4.

Department of Obstetrics and Gynecology, Zanjan University of Medical Sciences, Zanjan, Iran.

Optimal management of women with placenta accreta requires accurate preoperative diagnosis. Therefore, this study was conducted with the aim to evaluate a new prediction scoring items for risk assessment on placenta accreta and determine its accuracy ratio. This prospective cohort study was carried out on 159 suspected pregnant women morbidly adherent placenta (MAP) in Shariati, Imam Khomeini, and Yas Hospitals in Tehran from October 2016 to May 2018. The number of previous cesarean deliveries; lacunae stage, location of placenta; Doppler assessment; and loss of clear zone were used for review and scoring of ultrasound images. Ultimately after collecting scores, subjects fall into one of the following three categories: low (≤5 points), moderate (6-7 points), or high (8-10 points) probability for placenta accreta. Ultimately, diagnosis of accreta was based on hysterectomy during surgery or reports of pathology. A logistic regression model was used to calculate the probability of placenta accreta on univariable analysis, to assess the discriminant power of all explanatory variables assessed by the receiver operating characteristic (ROC) curve. The area-under-the-ROC curve of the composite scores was 98% and the overall sensitivity, specificity, and positive and negative predictive values of our developed scoring system were 91.84%, 87.27%, 86.54%, and 92.31%, respectively. Combination of several simple ultrasound and clinical characteristics in a scoring system may be highly effective for prenatal risk assessment and prediction of placenta accreta. Output of scoring system helps medical staff to prepare appropriately before surgery and avoid perinatal mortality and morbidity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/14767058.2018.1531119DOI Listing
June 2020

Adnexal mass with extremely high levels of CA-125 and CA19-9 but normal Human Epididymis Protein 4 (HE4) and Risk of Ovarian Malignancy Algorithm (ROMA): Endometriosis or ovarian malignancy? A case report.

Int J Reprod Biomed 2018 Jun;16(6):413-416

Endometriosis Research Center, Department of Obstetrics and Gynecology, Iran University of Medical Sciences (IUMS), Tehran, Iran.

Background: It has been shown that Carbohydrate antigen (CA) 125 and CA 19-9 tumor markers are useful for diagnosis and follow up of ovarian carcinoma.

Case: In this case, we reported the high level of CA-125 and CA 19-9 with large right ovarian intact endometrioma and extensive involvement of omentum.

Conclusion: Human Epididymis protein (HE4) and Risk of ovarian malignancy algorithm (ROMA) can be useful in differentiation between malignancies and benign pathologies with a good sensitivity and specificity value.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6079310PMC
June 2018

Comparison of intramuscular progesterone with oral nifedipine for treating threatened preterm labor: A randomized controlled trial.

Med J Islam Repub Iran 2017;31:56. Epub 2017 Sep 6.

Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, Iran.

Threatened preterm labor (TPL) is the leading cause of hospitalization during pregnancy. Tocolytic agents are the primary therapeutic options for TPL. The aim of this study is to compare intramuscular progesterone with oral nifedipine as a tocolytic agent. This randomized controlled trial was carried out in a teaching hospital (Shahid Akbarabadi) in Tehran, Iran, from December 2011 to November 2012. Three hundred and fifteen singleton pregnant women aged >18 yrs at 26-34 weeks' gestation with the diagnosis of threatened preterm labor (TPL) were randomly received either intramuscular progesterone or oral nifedipine for tocolysis. Maternal and neonatal outcomes were then compared between the two interventions. P value less than 0.05 was considered statistically significant. IRCT registration number of this study is IRCT201112198469N1 The success rate of progesterone and nifedipine in treating TPL were 83% and 82.7%, respectively. There was no significant difference between the two interventions with regard to gestational age at delivery, type of delivery, the time interval until the delivery, birth weight, NICU admission rate and hospital stays. Progesterone administration was associated with lower duration of NICU stay as compared with nifedipine (0.33±0.77 days vs.1.5±3.2 days, p<0.05). None of the two drugs caused any major side effects. Single dose intramuscular progesterone is as effective as oral nifedipine in treating TPL. It also significantly reduces the NICU stay.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.14196/mjiri.31.56DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5804454PMC
September 2017

Comparison between maternal and neonatal outcome of PPROM in the cases of amniotic fluid index (AFI) of more and less than 5 cm.

J Obstet Gynaecol 2018 Jul 9;38(5):611-615. Epub 2018 Feb 9.

b Department of Obstetrics & Gynecology , Iran University of Medical Sciences, Akbarabadi Teaching Hospital , Tehran , Iran.

The study was performed on pregnant women with a gestational age of 26-32 weeks of pregnancy, who had been admitted to the hospital with a confirmed diagnosis of premature rupture of membranes. In all eligible women, ultrasounds were performed for the evaluation of amniotic fluid index. Then, the women were divided into two groups according to amniotic fluid index of ≥5 cm and <5 cm. These women were followed and monitored up to delivery. The women of the two groups did not have significant difference between them according to age, gestational age at the time of ruptured membrane, body mass index, gravidity, parity, gestational age at delivery and route of delivery. Maternal morbidities including chorioamnionitis, placental abruption, uterine atony after delivery and retention of placenta did not show significant difference between the two groups. There was no significant difference between the two groups' amniotic fluid index <5 cm and amniotic fluid index ≥5 cm, regarding neonatal morbidities, except for neonatal sepsis and neonatal death, which were higher in the amniotic fluid index <5 cm group [7(14.6%) versus 1(2.3%), p = .039, RR = 7.7 (95%CI 0.04-0.06) and 11(30.9%) versus 2(4.7%), p = .013, RR = 6.095 (95%CI = 1.26-29.31)]. In the subgroups of two categories of gestational ages of 26-29 and 30-34, neonatal morbidities were higher in the amniotic fluid index <5 cm group. The results suggest that amniotic fluid index <5 cm should be considered as a warning sign for predicting poor prognosis of pregnancy complicated by preterm premature rupture of membranes. Impact statement What is already known on this subject? In a retrospective study in 1993, the relationship between oligohydramnios (which was defined as the largest single packet of fluid less than 2 × 2 cm) at the time of hospital admission, and the outcome of mother, foetus and neonates in a gestational age of less than 35 weeks of pregnancy was evaluated. In the oligohydramnios group, chorioamnionitis and funistis were more common. Also, the mean gestational age at the time of delivery and neonatal weight was less than that of the normal amniotic fluid group. According to these results, it was concluded that a low amniotic fluid volume in the women with preterm premature rupture of membranes (PPROM) can be considered as a prognostic factor in the cases of conservative management of PPROM. In contrast, the other study, which was performed on a larger sample size (290 patients), could not show more cases of amnionitis in the cases of amniotic fluid index (AFI) of less than 5 cm; however, the latency period was shorter in comparison with AFI of more than 5 cm. What do the results of this study add? Chorioamnionitis, placental abruption and uterine atony after delivery, retention of placenta and route of delivery did not show a significant difference between the two groups. Respiratory distress syndrome (RDS), need of surfactant and intubation, intra ventricular haemorrhage (IVH) and duration of neonatal intensive care unit (NICU) admission did not show a significant difference between the two groups; however, the rate of neonatal sepsis and neonatal death were higher in the AFI <5 cm group. What are the implications of these findings for clinical practice and/or further research? The results suggest that AFI <5 cm should be considered as a warning sign for predicting poor prognosis of pregnancy complicated by PPROM.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/01443615.2017.1394280DOI Listing
July 2018

Bilateral Hyperplasia of Bartholin's Gland: A Case Report.

Iran J Med Sci 2017 Jul;42(4):412-415

Department of Obstetrics and Gynecology, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.

A 37-year-old woman underwent surgery to remove bilateral vulvar masses. The masses were firm, non-tender, and immobile. Pathologic finding was a well-delineated creamy grayish mass with a homogenous grayish solid surface and mild edema, chronic inflammatory infiltration, and focal dilation of the ducts with squamous metaplasia. The diagnosis was hyperplastic and hypertrophied Bartholin's gland. Hyperplasia is a rare etiology for an enlarged Bartholin's gland. Clinical presentation of Bartholin's gland nodular hyperplasia is rather specific, although inflammatory lesion is the most common cause of swelling of the Bartholin's gland in all age groups. Bartholin's hyperplasia should be considered in cases with a solid mass. Total surgical excision is required for diagnosis. Only a few cases of Bartholin's gland hyperplasia have been reported in the literature. Our patient has been receiving regular follow-up examination and there is no evidence of dyspareunia, perineal pain, and recurrent disease 12 months after surgery.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5523051PMC
July 2017

Ultrastructural Investigation of Pelvic Peritoneum in Patients With Chronic Pelvic Pain and Subtle Endometriosis in Association With Chromoendoscopy.

J Minim Invasive Gynecol 2017 01 29;24(1):114-123. Epub 2016 Sep 29.

Endometriosis and Gynecologic Disorders Research Center, Department of Obstetrics and Gynecology, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.

Study Objective: To evaluate the pelvic peritoneum under chromoendoscopy by scanning electron microscopy (SEM) as well as light microscopy with hematoxylin and eosin staining and immunohistochemistry (IHC) assays in patients with chronic pelvic pain (CPP) associated with subtle endometriosis.

Design: Case series study (Canadian Task Force classification II).

Setting: A referral academic community tertiary medical center.

Patients: Three women aged 29 to 37 years were referred to the obstetrics and gynecology clinic of the tertiary university hospital with CPP. They were suspicious for endometriosis, were not responding to medical treatments, and had undergone previous pelvic laparoscopy to determine the stage of endometriosis and preparation of peritoneal samples under the guidance of staining with methylene blue in 0.25% dilution.

Interventions: Comparison of stained and unstained pelvic peritoneal samples after the instillation of 0.25% methylene blue into the pelvic cavity.

Measurements And Main Results: In 3 patients, laparoscopic examination showed minimal endometriosis. A total of 18 samples (9 stained and 9 unstained) from the 3 patients were prepared for SEM. Ten of the samples (55.6%) showed microstructural peritoneal destruction (7 of 9 stained [77.7%] and 3 of 9 [33.4%] unstained). Eighteen samples (9 stained and 9 unstained) from the 3 patients were also prepared for IHC. Six of these samples (33.3%) were S-100-positive, including 4 of 9 (44.4%) stained samples and 2 of 9 (22.2%) unstained samples.

Conclusions: In general, in the context of CPP and endometriosis, there is no established relationship between the severity of pain and stage of endometriosis. In the pathophysiology of CPP associated with endometriosis, ultrastructural changes can play a significant role. Under methylene blue staining, some destroyed areas were detected, but the stained areas do not necessarily correlate with increased microstructural peritoneal destruction.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jmig.2016.09.013DOI Listing
January 2017

Predictive value of 4-, 8-, and 12-h urine protein and protein-to-creatinine ratio for detection of pre-eclampsia.

Int J Gynaecol Obstet 2016 Jul 8;134(1):62-5. Epub 2016 Apr 8.

Rasoul-e-Akram Hospital, Department of Obstetrics and Gynecology, Iran University of Medical Sciences, Tehran, Iran. Electronic address:

Objective: To evaluate the accuracy of protein measurement and protein-to-creatinine ratio (PCR) in 4-, 8-, and 12-h urine samples as compared with 24-h urine samples as the gold standard method for suspected pre-eclampsia.

Methods: In a prospective study, 120 women at more than 20weeks of pregnancy with high blood pressure and no history of hypertension were enrolled between April 2010 and December 2012. Net protein excretion and PCR were evaluated in urine samples collected over 4h, 8h, 12h (day), and 12h (night) and compared with 24-h protein excretion as the gold standard test.

Results: A significant positive correlation was found between the values of the 4-h, 8-h, 12-h (day), and 12-h (night) samples and the 24-h samples. The best cutoff point of the PCR to detect significant urine protein excretion was 0.28, 0.24, 0.25, and 0.23 for the 4-h, 8-h, 12-h (day), and 12-h (night) samples, respectively.

Conclusion: Measurement of protein and PCR in 4-h, 8-h, and 12-h urine samples might provide an alternative test for detecting proteinuria among pregnant women with suspected pre-eclampsia when there is insufficient time to collect 24-h urine samples.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijgo.2015.11.023DOI Listing
July 2016

Chiropractic: Is it Efficient in Treatment of Diseases? Review of Systematic Reviews.

Int J Community Based Nurs Midwifery 2015 Oct;3(4):244-54

Department of Medical Ethics, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.

Chiropractic is a complementary medicine that has been growing increasingly in different countries over recent decades. It addresses the prevention, diagnosis and treatment of the neuromusculoskeletal system disorders and their effects on the whole body health. This study aims to evaluate the effectiveness of chiropractic in the treatment of different diseases. To gather data, scientific electronic databases, such as Cochrane, Medline, Google Scholar, and Scirus were searched and all systematic reviews in the field of chiropractic were obtained. Reviews were included if they were specifically concerned with the effectiveness of chiropractic treatment, included evidence from at least one clinical trial, included randomized studies and focused on a specific disease. The research data including the article's first author's name, type of disease, intervention type, number and types of research used, meta-analysis, number of participants, and overall results of the study, were extracted, studied and analyzed. Totally, 23 chiropractic systematic reviews were found, and 11 articles met the defined criteria. The results showed the influence of chiropractic on improvement of neck pain, shoulder and neck trigger points, and sport injuries. In the cases of asthma, infant colic, autism spectrum disorder, gastrointestinal problems, fibromyalgia, back pain and carpal tunnel syndrome, there was no conclusive scientific evidence. There is heterogeneity in some of the studies and also limited number of clinical trials in the assessed systematic reviews. Thus, conducting comprehensive studies based on more reliable study designs are highly recommended.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4591574PMC
October 2015

Designing and conducting MD/MPH dual degree program in the Medical School of Shiraz University of Medical Sciences.

J Adv Med Educ Prof 2015 Jul;3(3):105-10

Research Center for Traditional Medicine and History of Medicine, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.

Introduction: Many studies have focused on the need of health systems to educated physicians in the clinical prevention, research methodology, epidemiology and health care management and emphasize the important role of this training in the public health promotion. On this basis, Shiraz University of Medical Sciences (SUMS) has established MD/MPH dual degree program since the year 2012.

Methods: In the current study, Delphi technique was used. Both qualitative and quantitative methods were applied in the Delphi process. The Delphi team members including experts with extensive experience in teaching, research and administration in the field of educational management and health/medical education reached consensus in almost 86% of the questionnaire items through three Delphi rounds. MD/MPH program for SUMS was designed based on the items agreed and thematic analysis used in these rounds.

Results: The goals, values, mission and program requirements including the period, the entrance condition, and the number of units, and certification were determined. Accordingly, the courses of the program are presented in parallel with the MD education period. MPH courses consist of 35 units including 16 obligatory and 15 voluntary ones.

Conclusion: Designing MD/MPH program in SUMS based on the existent models in the universities in different countries, compatible with educational program of this university and needs of national health system in Iran, can be a beneficial measure towards promoting the students' knowledge and theoretical/practical skills in both individual and social level. Performing some additional research to assess the MD/MPH program and some cohort studies to evaluate the effect of this program on the students' future professional life is recommended.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4530000PMC
July 2015

Applying Quality Function Deployment Model in Burn Unit Service Improvement.

J Burn Care Res 2016 Sep-Oct;37(5):e440-52

From the *Shiraz University of Medical Sciences, Islamic Republic of Iran; †Department of Health Services Management, School of Health Management and Information Sciences, Tehran University of Medical Sciences, Iran; and ‡Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Iran.

Quality function deployment (QFD) is one of the most effective quality design tools. This study applies QFD technique to improve the quality of the burn unit services in Ghotbedin Hospital in Shiraz, Iran. First, the patients' expectations of burn unit services and their priorities were determined through Delphi method. Thereafter, burn unit service specifications were determined through Delphi method. Further, the relationships between the patients' expectations and service specifications and also the relationships between service specifications were determined through an expert group's opinion. Last, the final importance scores of service specifications were calculated through simple additive weighting method. The findings show that burn unit patients have 40 expectations in six different areas. These expectations are in 16 priority levels. Burn units also have 45 service specifications in six different areas. There are four-level relationships between the patients' expectations and service specifications and four-level relationships between service specifications. The most important burn unit service specifications have been identified in this study. The QFD model developed in the study can be a general guideline for QFD planners and executives.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/BCR.0b013e3182920d55DOI Listing
March 2018
-->