Crescent Journal of Medical and Biological Sciences
Year:2020 | Volume:7 | Issue:2|Papers Count:26

The coronaviruses are the family of single-stranded ribonucleic acid (RNA) viruses which are named because of their crown-shaped glycoprotein envelope structure. The coronavirus 2019 (COVID-19) is the “ novel” member of the family and its epidemic spread originated in Wuhan, China via animal-to-human transmission. Similar to the other members of the family, the novel coronavirus causes respiratory symptoms ranging from mild to severe (1). Thus, it is suggested that COVID-19 transmission is through the respiratory droplets that carry the virus. In special cases, it can also happen via aerosol transmission (2). . . .

Objectives: Choriocarcinoma spheroids, as acceptable three-dimensional (3D) models of the embryo, vary in the number of incorporated cells based on the procedures of production. Since the secretion of emitted signals from spheroids can modulate endometrial confrontation responses, improving a high throughput standard assay is precisely demanding for normalizing the characteristics of spheroids based on cellular enumeration. Materials and Methods: Spheroids derived from the suspension culture of the BeWo cell line were dimensionally categorized into three groups with sizes of 50, 100, and 200 μ m in diameters. The volume of each spheroid was determined according to 4/3π r3 formula and MTT and neutral red uptake (NRU) assays were applied as conventional and modified procedures. Furthermore, the categorized groups of spheroids were enzymatically dissociated and stained by the Trypan blue dye to precisely enumerate the number of incorporated cells based on volume alterations. Results: The absorbance of spheroids in modified MTT and NRU procedures with respect to the conventional ones resulted in higher correlation coefficients with volume alterations. Similarly, modified MTT and NRU procedures with respect to the conventional ones resulted in higher correlation coefficients between the cells numeration and volume alterations. Finally, the sensitivity of modified MTT assay was higher than modified NRU assay regarding accurately estimating the number of incorporated cells per spheroid. Conclusion: In general, the modification of MTT and NRU procedures can amplify the potential of both assays to enumerate the cell number of 3D aggregates. Exclusively, the modification of MTT assay brought it as an ideal high throughput assay with high sensitivity to screen the cell number of spheroids with a diameter of 200 μ m and less.

Objectives: In the field of health, procrastination is a relatively new but important issue. Most studies on procrastination deal with academic procrastination while no study, to the best of our knowledge, is available regarding the issue of health-related procrastination. Therefore, the present study was conducted to discover the attributes, causes, and outcomes of the health-related procrastination in nurses. Materials and Methods: This conventional, qualitative, content analysis was conducted on 13 nurses (including 5 males and 8 females with a mean age of 34. 76 years) from academic hospitals affiliated with Iran University and Gonabad University of Medical Sciences using a purposive sampling technique. The data were collected from October 2016 to December 2017 through face-to-face semi-structured interviews and field notes. Results: The attributes of procrastination included a gap between intention and action, illogical delays, and delays in doing health tasks. The factors included present-biased and comfort over hardship preferences, risk taking, avoidance behaviors, self-satisfaction, inner tendencies, the nursing job, the nature of the problem, and beliefs. The outcomes included psychological, physical, and social problems. Conclusions: The results of this study provided an in-depth understanding of the concept of health-related procrastination. Thus, the findings can help design health education interventions and promote nurses’ health.

Objectives: Successful marriage and the strengthening family foundation bring about numerous positive outcomes for both the family and society. Therefore, the purpose of this study was to investigate the concept and dimensions of successful marriage from the perspective of successful couples and experts in this field. Materials and Methods: This qualitative study was done by the conventional content analysis method through the participation of 10 Iranian couples (10 men and 10 women) and 14 experts in related courses to marriage. The research environment was health centers. The couples entered our study after obtaining at least %70 of the score from the ENRICH questionnaire. The sampling was done purposefully and the data were collected using unstructured in-depth interviews and continued until achieving saturation. In the meantime, data analysis was conducted using a conventional content analysis method. Results: The obtained main concepts from the data were four main themes and ten main categories. The main theme included recognizing and understanding the needs, life skills, personality liberation, along with development and flourishing Conclusions: For a successful marriage, the couple’ s premarital knowledge of each other and their spouse’ s family, knowing necessary life skills, as well as recognizing and understanding married life are necessary. Moreover, the couples will acquire the necessary development and flourish to manage married life through achieving positive behavioral qualities including personality liberation. To achieve success in married life, one cannot ignore the role of training in acquiring life skills both before and after the married life.

Objectives: The communication is not just being able to verbally pronounce words and sentences, but it includes understanding information through inspiration, inner instinct, or external guidance. To achieve a better quality of life (QoL), there is a need for determining pleasant communication. The current study aimed to explore the women’ s perception about different aspects of communication in their life. Materials and Methods: This qualitative content analysis aimed to understand the meaning of communication as a key factor in Iranian women’ s QoL, which was conducted on 40 women. The data were gathered through depth interviews from May to November 2016 in Tehran, Iran. The interviews were transcribed verbatim and analyzed using conventional qualitative content analysis in 8 stages recommended by Zhang. Results: Two categories were identified based on the interviews, including constructive spiritual and pleasant peripheral communication and each theme consisted of some categories. Conclusions: Overall, awareness about different aspects of communication in women’ s life must be considered by politicians and health care providers in Iran. In addition, efforts would be made to improve nurses’ understanding of different aspects of the QoL, especially pleasant communication in women’ s life which could help their health promotion.

Objectives: Uterus is one of the most important organs of a woman which purifies the blood and carries a fetus and its function is related to the main organs like the brain, heart, liver, kidneys, and stomach. Uterine distemperaments are among the most important diseases of this organ and various symptoms are mentioned for them in Persian medicine (PM). Accordingly, the evaluation of these symptoms will help the diagnosis and treatment of different types of disorders related to the female reproductive system. Materials and Methods: This concept analysis qualitative study was conducted to collect and classify the symptoms of uterine distemperaments using a hybrid method and included theoretical, fieldwork, and analysis phases. In the theoretical phase, the resources of PM were reviewed, followed by interviewing the experts of PM and patients with uterine distemperament in the fieldwork phase. Finally, the guidelines were provided for diagnosing uterine warm and cold distemperaments. Results: The signs and symptoms of uterine distemperaments were classified into 5 general categories including menstrual blood characteristics (i. e., volume, consistency, color, smell, temperature, and outgoing speed), uterine discharges, pubic hair characteristics, other characteristics related to the female reproductive system, and the general symptoms. Eventually, the most important concepts were converted to a guideline of “ Major and Minor Diagnostic Criteria for Uterine distemperaments” . Conclusions: In general, the recognition of the symptoms of uterine distemperaments facilitates the prevention, diagnosis, and treatment of different types of gynecologic disorders. The results of the current study can be an appropriate basis for designing and standardizing diagnostic tools for uterine distemperaments and related diseases.

Objectives: The treatment of irritable bowel syndrome (IBS) is not curative and is based on patient symptoms. Some herbal medicines have significant effects on IBS symptoms. The present study aimed to assess the efficacy of a recommended drug from Persian medicine (Cumin Sofouf) on the score of IBS symptom severity and the quality of life as a clinical trial compared with mebeverine, which is a commonly used antispasmodic drug for this disorder. Materials and Methods: In this double-blind randomized clinical trial, eligible patients were allocated to two groups. One group received 200 mg sustain release mebeverine capsule plus placebo sofouf and another group received the sachets of cumin sofouf plus placebo capsule. Cumin sofouf contains the seed powder of Bunium persicum, Trachyspermum ammi, Foeniculum vulgare, and Pimpinella anisum. Patients were requested to fill IBS-symptom severity score (IBS-SSS) and IBS-quality of life (IBS-QoL) questionnaires at the base and after 4 weeks of treatment. Results: Data of 40 patients in each group entered the analysis step. Based on the results, IBS-SSS decreased by 120. 13 (SD = 66. 04) and 70. 75 (SD = 50. 75) point after 4 weeks in cumin sofouf and mebeverine groups, respectively. in addition, cumin sofouf was statistically more effective than mebeverine, which was also about IBS-SSS substructures. Further, the IBS-QOL score decreased by 17. 40 (SD = 13. 66) and 8. 55 (SD = 6. 88) point in sofouf and mebeverine groups, respectively. Finally, cumin sofouf was significantly more effective than mebeverine. Conclusions: According to the results, cumin sofouf could be recommended as a supplementary remedy for IBS patients.

Objectives: Discrimination can entail important negative consequences on the health of individuals and older women could be exposed to social discrimination in different contexts, especially the family, because of their age and gender. Few studies have specifically studied the discrimination of older women and its effects on health. The aim of the present study was to translate and determine the psychometric characteristics of Everyday Discrimination Scale (EDS) in community-dwelling Iranian older women in Tehran and evaluate relationship between discrimination and health. Materials and Methods: This research was conducted on 250 community-dwelling women aged 60 and over in Tehran, Iran. EDS was translated based on the protocol introduced by the World Health Organization (WHO). Content validity index (CVI) was assessed for content validity based on expert opinion. Construct validity of EDS was investigated using confirmatory factor analysis (CFA), and its reliability was evaluated by calculating the degree of internal consistency and stability. Mean of perceived discrimination was compared in two groups with good and poor self-rated physical health. Results: The mean age of subjects was 67. 9 ± 6. 5 years. The results showed that content validity (SCVI = 0. 9, SCVI/AVG = 0. 91), construct validity (high correlation of each item with the factor and optimality of fitness indices in CFA) and reliability (α = 0. 91, intraclass correlation [ICC] = 0. 91, and test-retest correlation=0. 77, P < 0. 001 ) of EDS tool were optimal and suitable for Iranian older women. Perceived discrimination was significantly higher in older women with poor physical health. Conclusions: EDS has an appropriate validity and reliability in assessing perceived discrimination among Iranian older women in the context of family relationship and perceived discrimination negatively affect physical health.

Objectives: The progresses in information and communication technology, the increase in medical and nursing knowledge, the need for new methods for processing, maintaining and retrieving information for the production of new knowledge and also the economic benefits of the use of information and communication technology are the reasons for the importance of nursing informatics. This study was conducted with the aim of determining the skills of nursing informatics and need assessment for designing nursing informatics curriculum in Iran. Materials and Methods: It was a mixed method study in which Delphi technique was used. The research population included nursing and medical informatics specialists who were a member of the faculty of medical universities of the country with a Ph. D. degree. Purposive and snowball sampling were used, and 45 people participated in this study. The data collection was first carried out on the basis of a review of the texts and global experiences. The researcher made questionnaire was sent through email in two steps. Focus group comments were used to complete and finalize the skills. Results: Based on the results, 81% of the experts considered the design of a course in nursing informatics essential and, expressed their positive views on nursing informatics and considered it as a missing link in the application of informatics knowledge in nursing, which can contribute to beneficial change, innovation and professional development of existing knowledge in nursing. Nursing informatics skills were designed with 28 items in 4 domains. The role of graduates was determined in the areas of care with 6 tasks, training with 5 tasks, research with 5 tasks, and management with 5 main tasks. Conclusions: The findings showed the importance of nursing informatics in the areas of training, research, management and clinical education. Moreover, the results showed that designing nursing informatics curriculum for postgraduate degree is a necessity which was approved by Nursing and Medical Informatics Experts. The findings of this study can be used for designing curriculum in the field of nursing informatics.

Objectives: Abnormal uterine bleeding (AUB) is a disorder which adversely influences the social status and level of satisfaction in women with reproductive ages. Improving health-related quality of life (HRQL) is a precious goal in the treatment of AUB. The aim of this study was to evaluate the QOL in patients with AUB and the affecting factors. More precisely, this study attempted to assess which different aspects of QOL may be influenced by AUB. Materials and Methods: This cross-sectional study was performed on 152 women with AUB refereeing to our gynecology and obstetrics department of a tertiary center in Semnan, Iran in 2015-2016. The QOL was investigated in these women using Clinical History Assessment Tool (CHAT) and SF-36. Finally, the data were analyzed in SPSS-21 software and after performing Fisher exact test and K2 test, P < 0. 05 was considered to be significant. Results: In general, 152 patients were enrolled in our study. The results suggested that the QOL and level of life satisfaction were not changed according to the age, gender, matrimonial status, place of residence, occupation, education, body mass index, or the hemoglobin level in this group. However, menorrhagia significantly affected the dimensions of physical functioning, vitality and dynamism, social functioning, and pain and general health perception. Conclusions: Overall, women with AUB, especially those with menorrhagia, have extremely lower QOL than the others. By recognizing all contributing factors to the QOL in such women, it can be possible for gynecologists to help the women improve their diary functions and comfort levels. Nonetheless, more studies seem to be needed to evaluate these factors.

Objectives: In recent decades, fertility has decreased significantly in Iran. In many countries, childlessness is one of the major causes of low fertility. Thus, the present study focused on whether we are facing a dramatic increase in voluntary and involuntary childlessness in Iran that leads to lower fertility. Materials and Methods: Using secondary data analysis of 2000 and 2011 Iran Demographic and Health Survey (IDHS) and Individual Level Data from the 1996-2016 Census Sample Files, the study aimed to estimate childlessness and to assess the level of voluntary and involuntary childlessness in Iran. The Kaplan-Meier survival function was also used to estimate the percentage of women who fail to have a first birth after marriage. Results: According to the census data, the proportion of childless women within the age group of 15-39 increased during 1991-2016. In contrast, the rate of lifetime childlessness remained around 4% by 2011 and then raised slightly by 2016 and reached 5%. The survival function of childlessness showed that only 4 and 6. 5% of women in 2000 and 2011 remained childless after 10 years of marriage, respectively. Conclusions: With regard to the low lifetime childlessness rate, advances in the health system, and ideal fertility above two children, it was concluded that the fertility decline in Iran is associated with a decrease in the number of large families and the long birth interval and no rise in childlessness. Although providing support for infertile couples is important, any exaggerated claim about voluntary and involuntary childlessness leads to the adaption of inappropriate and ineffective policies toward increasing fertility.

Objectives: Multiple studies have shown that vitamin D deficiency can increase the risk of cardiovascular disorders. However, the role of vitamin D in increasing the risk of coronary atherosclerotic disorders and cardiac dysfunction is yet unknown. Accordingly, the present study aimed to assess the relationship between the serum level of vitamin D and the echocardiographic indices of the left ventricular (LV) function or valvular defects. Materials and Methods: This cross-sectional study was performed on 80 consecutive patients who were the candidate for diagnostic coronary angiography and demonstrated a sign of slow coronary flow (SCF) or minimal coronary artery disease (CAD) while without any evidence of CAD. The serum level of 25-hydroxy vitamin D was measured by ELISA (enzyme-linked immunosorbent assay) method. Finally, patients were evaluated by transthoracic 2D, Doppler echocardiography, and tissue Doppler imaging in order to investigate the systolic and diastolic function of the left ventricle. Results: Based on angiography reports, 36. 2% of patients had normal coronaries while 50. 0%, 7. 6%, and 6. 2% of them were diagnosed with isolated minimal CAD, isolated SCF, and a combination of minimal CAD and SCF, respectively. In addition, the mean serum level of 25-hydroxy vitamin D in our patients was 30. 33 ± 19. 27. Further, the mean level of this parameter was 29. 37 ± 22. 16, 30. 39 ± 16. 22, 18. 24 ± 4. 32, and 44. 65 ± 25. 52 in the normal coronary group, as well as patients with isolated minimal CAD, concurrent minimal CAD and SCF, and those with isolated SCF, respectively, indicating no significant difference among the groups regarding 25-hydroxy vitamin D concentration (P = 0. 147). Furthermore, the level of 25-hydroxy vitamin D had no relationship with the echocardiography indices of the LV function or valvular defects. Conclusions: In general, the serum level of 25-hydroxy vitamin D may not be a predictive factor for the LV function or valvular defects.

Objectives: The present study aimed to develop a valid and reliable questionnaire regarding the stages of change in the self-management of patients with type 2 diabetes mellitus (T2DM). Materials and Methods: In the first section of this cross-sectional study, the stages of change in self-management of patients with T2DM questionnaire were developed by the researcher. The questionnaire included eight questions in the field of using medication, a healthy diet, and physical activity. In the second section, the content validity and face validity of the questionnaire were assessed by the opinions of 11 expert panelists in the field of health education and nutritional sciences. Finally, construct validity was carried out by exploratory factor analysis (EFA) among 206 patients with T2DM in an outpatient clinic in Ardabil in the northwest of Iran. Results: The total content validity index (CVI), content validity ratio (CVR), and face validity were 0. 60-0. 91, 0. 81-1, and 4. 32-4. 82, respectively. The number of questions increased up to 10. In addition, EFA results showed that Kaiser-Mayer-Olkin and the total variance extracted were 0. 69 and 23. 6, respectively, and Bartlett tests were statistically significant (P=0. 000). Finally, reliability analysis indicated a moderate level of internal consistency (ICC = 0. 89) and Cronbach’ s alpha of 0. 63. Conclusions: This questionnaire with 10 items and one factor was found to be valid and reliable as a simple and effective tool for self-care on the stages of change in patients with T2DM.

Objectives: Congenital cardiac disorders are the most prevalent congenital disorders which require interventional or surgical treatments. The most common causes of complete heart block (CHB) are the degeneration of the cardiac conduction system, acute myocardial infarction, and congenital cardiac disorders. CHB after congenital heart surgery is very important and a major cause of post-operation death and heart failure. In addition, the application of a pacemaker is a standard treatment for CHB. Thus, the aim of this paper was to study the frequency of early postoperative CHB in patients with congenital cardiac diseases and the need for temporary (TPM) and permanent (PPM) pacemakers. Materials and Methods: This descriptive-analytical and cross-sectional study was conducted on children with congenital heart defects who underwent open heart surgery in Shahid Madani hospital of Tabriz from 2011 to 2016. Patients with early postoperative CHB were included in the study. Further, those who improved on their own and those who needed TPM and PPM were identified, followed by assessing the frequency of CHB and the need for TPM and PPM. Results: In general, 109 out of 2100 operated patients developed early postoperative heart block and the frequency of early CHB after open heart surgery was 5. 19%. Furthermore, 69 (63. 3%) out of 109 patients with early postoperative CHB needed TPM and 9 patients needed PPM while 22 patients improved without pacemakers. This rate is acceptable from the occurrence of CHB and the use of PPM and TPM in comparison with other centers and studies. It can reduce mortality and morbidity in patients with timely diagnosis and interventions. Conclusions: To conclude, the prevalence of early CHB in patients operated for congenital cardiac diseases was 5. 19. Finally, the need for TPM was high and most of the patients improved cardiac rhythm with no need for PPM or TPM.

Objectives: Calprotectin is released from neutrophils and monocytes during the inflammatory process. Recently, an increasing number of studies has postulated some possible diagnostic roles of fecal calprotectin (FC), including the inflammatory bowel disease (IBD). Considering that mesenteric lymphadenopathy is due to the inflammation of lymph nodes, it can be assumed that FC can be used as an early diagnostic tool for mesenteric lymphadenopathy. Thus, the aim of this study was to evaluate the association between FC and mesenteric lymphadenopathy in children. Materials and Methods: Children with abdominal pain admitted to Tabriz Pediatric Hospital were included in this cross-sectional, case-control study during one year. Patients were allocated to two groups based on ultrasonography (US). The case group consisted of children with mesenteric lymphadenopathy revealed by the US while the control group included children without mesenteric lymphadenopathy. Finally, the demographic data and FC concentration, along with other routine laboratory tests were assessed in both groups. Results: Overall, 119 children were included of whom, 47 and 71 children were in the control and case groups, respectively. The median FC of the case and control groups was 50 and 46. 7 μ g/g ranging from 6. 5-1800 and 5-1000 μ g/g, respectively, demonstrating a significant difference between the groups (P = 0. 001). The optimal cutoff point of FC was 46. 7 μ g/g for the diagnosis of mesenteric lymphadenopathy with 61. 1% sensitivity and 78. 7% specificity. Conclusions: The results of this study revealed that the level of FC in the case group was significantly higher compared to the control group. Therefore, the FC concentration could be the most useful method for the diagnosis of mesenteric lymphadenopathy.

Objectives: Acute myocardial infarction can cause the right ventricle (RV) dysfunction. The echocardiography (ECHO) can provide the first clue to RV involvement in patients with inferior MI. In addition, the echocardiographic assessment of RV function can help in the early diagnosis and management of these patients in whom ECG cannot be diagnosed for RV involvement. Consequently, the current study measured the right atrium (RA) volume index instead of conventional RV echocardiographic parameters in order to evaluate the RV function in patients with poor RV echo windows. Materials and Methods: To this end, 116 patients with inferior myocardial infarction (MI) (66 with isolated inferior and 50 with inferoRV MI) were included after 24-72 hours after MI. Furthermore, RV systolic function parameters were measured, including tricuspid annular plane systolic excursion (TAPSE), fractional area change, and peak systolic velocity of the tricuspid annulus at tissue Doppler imaging (TDI) mode (RVSm). Finally, monoplane Simpson’ s and biplane area length methods were used to measure RA volume index in these patients. Results: Based on the results, the RA volume index was high in both inferior and inferoRV MI patients but was significantly higher in inferoRV MI. Patients with inferoRV MI more likely had RAEF≤ 35%, high E/E’ , and high right ventricular enddiastolic diameter (RVEDD) compared to isolated inferior MI. The correlation between RAVI in both groups was very significant with E/E’ and RVEDD. Conclusions: RA volume index is a good parameter for demonstrating RV dysfunction in patients with inferior and inferoRV MI.

Objectives: An increase in the level of cortisol hormone caused by preoperative stress may have undesirable effects on the surgery. Thus, it is necessary to manage the level of this hormone. Therefore, this study aimed to investigate the effect of ear acupressure on stress and serum cortisol hormone levels before rhinoplasty surgery. Materials and Methods: The present randomized clinical trial study was carried out in six months and finished on August 21, 2019. In general, 66 participants were selected based on quadratic-block randomization at Imam Reza hospital, Tabriz. Ear acupressure group received the intervention in each ear twice a day for 10 minutes (the duration of each intervention) three days before the surgery. The data were recorded in the demographic form of Spielberger’ s implicit and explicit stress just before and three hours after each intervention. The data were analyzed by SPSS 21 using Kolmogorov-Smirnov, independent samples t test, and chi-square statistical tests and P < 0. 05 was considered statistically significant. Results: Before the intervention, both groups showed no significant differences (P > 0. 05) regarding the amount of implicit and explicit stress and serum cortisol levels (P < 0. 05). However, a significant difference was observed in the stress and cortisol levels of the participants of both groups after implementing the interventions. Regarding the inter-group differences, there were no statistically significant differences between the means of the control group both before and after the intervention (P > 0. 05). In contrast, the intervention group faced significant changes considering the level of stress and serum cortisol in the posttest. Conclusions: Overall, performing ear acupressure before rhinoplasty can reduce stress (implicit and explicit) and serum cortisol levels.

Objectives: Postpartum post-traumatic stress disorder (PTSD) is regarded as a life-threatening childbirth experience for mother or infant and may be accompanied with the risk of death or serious injury to the mother or her infant. Given the changes to diagnostic criteria of traumatic childbirth brought in with DSM-5 and considering the unfavorable outcomes of postpartum PTSD, this study was carried out to identify the determinants of postpartum PTSD. Materials and Methods: This cross-sectional study was conducted in 2018 on 310 postpartum women who had experienced a traumatic childbirth, based on the DSM-5 criteria, and referred to Tabriz health centers for routine care 42-60 days after the delivery. Subjects were selected through convenience sampling. Research instruments were demographic, obstetric, and neonatal information questionnaire, Post-Traumatic Stress Checklist for DSM-5 Criteria (PCL-5), Mackey Childbirth Satisfaction Rating Scale, and Winefield and Tiggemann Social Support Questionnaire. The data were analyzed using SPSS version 25. 0, and ANOVA, independent t-test, Pearson correlation coefficient test, Spearman correlation coefficient test, and multivariate linear regression were applied. Results: The mean score (± standard deviation) of postpartum PTSD was 42. 13 (± 11. 72). The determinants of postpartum PTSD also included complications during pregnancy, type of delivery, concordance between desired and actual type of delivery, method of placenta removal, analgesia, sleeping and neonatal states, satisfaction with childbirth, and perceived support during and after childbirth. Conclusions: Designing interventions to make childbirth more pleasant through provision of methods for a pain-free or pain-reduced childbirth, promotion of satisfaction with childbirth, and support during and after the childbirth seem to be essential for reducing postpartum PTSD.

Objectives: The present study was conducted to investigate the effect of motivational interviewing (MI) on dietary intake and weight changes among preconception women with obesity and overweight. Materials and Methods: This randomized controlled trial was conducted on 70 overweight and obese women (body mass index ≥ 25) within the age range of 18-35 years in the preconception period referred to health centers in Tabriz, Iran. Twenty-four-hour food records were completed by women for 3 days and participants’ weights were measured before and 8 weeks after the intervention. Using a random block design and the allocation ratio of 1: 1, the participants were divided into MI (6 sessions of training and MI) and control (routine preconception care) groups. The criterion for the primary outcome was the mean macronutrient intake 8 weeks after the intervention. All analyses were done according to intention to treat method. Results: At the baseline, there was no statistically significant difference in terms of the mean of daily energy intake, carbohydrates, fat, protein, and weight (P > 0. 05). After the intervention, the mean (standard deviation) of daily energy intake was 1841. 3 (567. 8 kcal) and 2131. 0 (568. 7 kcal) in intervention and control group, indicating a significant difference between the 2 groups with an adjusted mean difference (AMD) of-334. 3 and a 95% confidence interval (CI) of-667. 2 to-21. 5 (P = 0. 03). However, there was no difference between the 2 groups in terms of macronutrients (P > 0. 05). After the intervention, the mean (SD) of participants’ weight was 74. 4 (6. 94 kg) and 75. 7 (7. 82 kg) in intervention and control groups, which demonstrated a significant difference between the 2 groups (AMD =-1. 30 kg, 95% CI =-2. 09 to-0. 51, P = 0. 002). Conclusions: MI is an efficient method of weight loss and the energy intake change can help preconception women with obesity or overweight to safeguard themselves against the adverse consequences of their pregnancy.

Objectives: Cesarean section (C-section) is one of the most common surgeries for women, which has numerous complications including anxiety and vital sign changes. Various non-drug methods exist for controlling these complications. Although nurse companionship is one of such methods, there is little information about the accompaniment of mothers by trained nurses during the C-section surgery. This study aimed to determine the effect of “ nurse companionship” on the level of anxiety and vital sign changes of C-section candidates. Materials and Methods: Using a random allocation method, this randomized control trial was performed on 128 C-section candidates in Al-Zahra teaching hospital of Tabriz in 2017. In addition to routine cares, intervention group mothers were accompanied and supported by a nurse 1 hour before to after the C-section surgery while mothers in the control group only received routine cares for the C-section. Data collection tools were demographic information form, visual analogue scale (VAS), digital blood pressure monitor, and chronometer. The anxiety level and vital sign changes were measured one hour before, during, and one hour after the C-section surgery. Finally, data were analyzed by SPSS 24 using the mixed repeated measures ANOVA. Results: The comparison of the results of the two groups showed that the accompaniment of the mothers had a significant effect on reducing anxiety during (P < 0. 001) and 1 hour after (P = 0. 011) C-section surgery while it had no significant effect on vital sign changes. Conclusions: The results revealed the positive effect of nurse companionship on reducing mothers’ anxiety during and after the C-section surgery. Therefore, this method can be used as non-invasive nursing care during C-section surgeries and in operating rooms. However, cost-effectiveness assessment is recommended before the implementation of this method.

Objectives: There are conflicting reports on post-coronary artery bypass grafting (CABG) training programs that could have the most favorable impact on the hemodynamic state of patients. Therefore, the purpose of this study was to explore the effects of interval training on hemodynamic indices of patients following CABG. Materials and Methods: In this prospective quasi-experimental study (over the 4 months leading to July 2019), 24 patients were randomly selected based on a similar study. Among these patients, 12 cases (the training group) referring to Shahid Madani hospital of Tabriz received twelve 20-minute sessions of interval training over a month and their hemodynamic indices were measured before and after the intervention. The indices were then analyzed using the Shapiro-Wilk test, correlated t-test, and independent t test and P values lower than 0. 05 were considered statistically significant. Results: The intergroup comparison of hemodynamic indices between training and control groups showed a significant difference (P ≤ 0. 019). In addition, the intragroup comparison of pre-and post-intervention results demonstrated significant improvements in all hemodynamic indices of the training group after the intervention (P ≤ 0. 010) while the changes were not significant in the control group (P ≤ 0. 118). Conclusions: In general, the interval training program in the post-CABG period improved hemodynamic indices and patient rehabilitation.

Objectives: Placenta accreta spectrum (PAS) is a serious complication of pregnancy with maternal and fetal morbidity and mortality. Ultrasonography is a useful application in the prenatal diagnosis of PAS disorders. The main scope of this study was to assess the peak systolic velocity (PSV) of subplacental blood flow and its correlation with the clinical description of PAS disorders. Materials and Methods: In this cross-sectional study, 60 pregnant women with persistent anterior placenta previa in the third trimester of pregnancy were examined by color Doppler and grayscale ultrasonography for the diagnosis of PAS disorders. The PSV and resistive index (RI) of the subplacental blood flow were measured by spectrum Doppler in the anterior wall of the inferior uterine segment. Eventually, the patients were followed up until delivery and the correlation between PSV, RI, and PAS disorders was assessed post-surgery. Results: A total of 26 (43. 3%) out of 60 patients was diagnosed with PAS disorders. In cases with PAS disorders, the PSV of the subplacental blood flow was significantly higher (AUC = 0. 94, 95% CI = 0. 89-1. 00) compared to the not affected ones. In addition, the PSV of ≥ 43. 65 cm/sec with 100% specificity was determined as the optimal cut-off for the prenatal diagnosis of PAS disorders. Finally, the RI of subplacental blood flow showed no significant difference between the two groups (AUC = 0. 551, 95% CI = 0. 398-0. 705). Conclusions: Overall, the measurement of the PSV of the subplacental blood flow in patients with anterior placenta previa can increase the accuracy of the ultrasound diagnosis of PAS disorders.

Objectives: Physiotherapists have accepted the dry needling (DN) technique as an adequate treatment for myofascial trigger points (MTrPs). Considering that most similar studies have only focused on one muscle, the current study aimed at evaluating the influence of DN on patients with musculoskeletal pains caused by active MTrPs in shoulder girdle muscles. Materials and Methods: This quasi-experimental study was achieved based on experiences and observations in clinical settings. Totally, 20 subjects were selected with pain in shoulders and/or upper limbs, as well as head and neck with 3 to 5 MTrPs in the shoulder girdle muscles. They were candidates for treatment with DN in 5 sessions every other day during 2 weeks. The subjects were evaluated by the visual analogue scale (VAS), pressure-pain threshold (PPT), and the disabilities of the arm, shoulder, and hand (DASH). The statistical analysis was done using the paired t test. Results: A significant difference was observed in VAS, DASH, and PPT results after the intervention compared with those values before the intervention. P≤ 0. 05 was considered as the level of significance. Conclusions: Considering the observed improvements in VAS, the PPT, and DASH scores, the DN can be used as an impressive therapeutic method for MTrPs in shoulder girdle muscles.

Objectives: Regarding the increasing prevalence of hypertension and its associated disabilities, it is beneficial for physicians to build on the potential of other medical schools like Persian medicine (PM) as it can provide useful knowledge of the factors leading to hypertension by identifying its pathogenesis in another medical attitude. Thus, the present study aimed at applying a strategy to prevent and treat hypertension. Materials and Methods: The current qualitative brief report was initiated by reviewing valid databases. Subsequently, the risk factors of hypertension were extracted using keywords such as “ hypertension” , “ high blood pressure” , “ prevalence” , “ epidemiology” , and “ predisposing and risk factors” . Then, each of these factors was conceptually matched to the fundamentals (4 qualities or Mizaj) of PM by Avicenna in his book named “ The Canon of Medicine. Results: The known risk factors of hypertension were prone to occur in an individual before the onset of clinical hypertension due to his/her increased coldness (six items) and increased dryness (seven items). Given a few reports taking hypertension more associated with the warmth quality, it is probable that the patients with hypertension have a basically warm temperament, but they experience hypertension upon encountering with factors that result in increased coldness and dryness. Conclusions: Overall, the etiology and pathogenesis of hypertension can be better understood according to four qualities in PM. Therefore, hypertension is preventable in risky people by making modifications in lifestyle, and hence, changes in body qualities and orientation toward a relatively balanced state.

Coronary artery disease (CAD) is one of the most important health issues worldwide and is prevalent among Asians (1). In addition, CAD is still the leading cause of mortality and health-care cost around the world. About 2 million individuals have CAD in Iran and it emerges in the population 10 years earlier than the other countries (2). The most important psychological factors for cardiovascular diseases are stress, depression, and optimism/pessimism. . . .