pISSN: 1735-8949
eISSN: 1735-9392
Editor–in–Chief:
Fatemeh Davari Tanha, MD.
Vol 12, No 2 (June 2018)
Objective: Gestational diabetes mellitus is the most common metabolic and endocrine perinatal complication and is a growing health problem worldwide. Considering the fetal programming and its contribution as one of the evolutionary origins of human diseases, it is very important to improve the glucose metabolism in pregnant women, determination of other nutrients, preventing excessive accumulation of fetal fats, emphasis on weight loss measures before pregnancy, dietary intake with low-fat healthy food and prevention of abundant weight loss. In this paper, we have provided a brief review on dietary intake and dietary interventions in GDM from the perspective of nutrition science attending the physiopathology and etiology of the disease.
Materials and methods: Electronic search for English and Persian articles has been perform in databases, including Google Scholar, PubMed ,Scopus, Cochrane central ,Science direct, ISC, SID, Magiran, Iran Medex, and Med Libby key words: gestational diabetes, gestational diabetes mellitus, nutrition, macronutrient, micronutrient, Diabetes. All available articles (cross-sectional, descriptive-analytic, and clinical studies with desirable design and review quality studies were used. Reference books including Krause's Food and the Nutrition Care, The Williams Obstetrics editions of the 14th (2017) and the 24th edition (2014) were also reviewed.
Results: Nutrition therapy and physical activity are the initial treatment of GDM. Proper and flexible methods of nutrition therapy that successfully regulate maternal glycaemia while improving expected fetal growth have extensive concepts. Meanwhile, dietary supplements with proven beneficial effects can play an important role in improving deficiencies and improving the metabolic profile of patients.
Conclusion: Nutritional management is the main treatment for gestational diabetes mellitus and overweight/obesity is the principal contest in patient counseling and interventions during pregnancy. Despite extensive researches carried out, this field is an active research area and requires more clinical research to minimize maternal and fetal complications.
Objective: To evaluate the impact of bacteriospermia on semen parameters.
Materials and methods: We used the Medline (1966-2017), Scopus (2004-2017), Clinicaltrials.gov (2008-2017), EMBASE, (1980-2017), LILACS (1985-2017) and Cochrane Central Register of Controlled Trials CENTRAL (1999-2017) databases in our primary search along with the reference lists of electronically retrieved full-text papers. Meta-analysis was performed with the RevMan 5.3 software.
Results: Eighteen studies were finally included. Men were stratified in two groups, healthy controls (5,797 men) and those suffering from bacteriospermia (3,986 men). Total sperm volume was not affected by the presence of bacteriospermia when all pathogens were analyzed together (MD 0.02 95%CI -0.13,0.17). Both sperm concentration (MD -27.06, 95% CI -36.03, -18.08) and total sperm count (MD -15.12, 95% CI -21.08, -9.16) were significantly affected by bacteriospermia. Decreased rates of normal sperm morphology were also found (MD -5.43%, 95% CI -6.42, -4.44). The percentage of alive sperm was significantly affected by bacteriospermia (MD -4.39 %, 95% CI -8.25, -0.53). Total motility was also affected by bacteriospermia (MD -3.64, 95% CI -6.45, -0.84). In addition to this, progressive motility was significantly affected (MD -12.81, 95% CI -18.09, -7.53). Last but not least, pH was importantly affected (MD 0.03, 95% Cl 0.01, 0.04).
Conclusion: Bacteriospermia significantly affects semen parameters and should be taken in mind even when asymptomatic. Further studies should evaluate the impact of antibiotic treatment on semen parameters and provide evidence on fertility outcome.
Objective: Employed mothers face considerable amount of hazards. Especially shift work can impact pregnant women by affecting some hormones. This study was conducted to assess the adverse effects of shift work on pregnancy outcomes.
Materials and methods: This historical cohort study was conducted in 2017 in order to assess the effect of shift work on pregnancy outcomes. The subjects were consecutively selected from pregnant women, which referred to Al Zahra and Shahid Beheshti hospitals, Isfahan, Iran for their pregnancy care. The effect of shift work on pregnancy and labor complications (low birth weight, small for gestational age, pre-eclampsia and eclampsia, intra-uterine growth retardation, spontaneous abortion, preterm delivery, excessive bleeding during labor, and type of labor) was assessed. The effect was adjusted for occupation and number of children as well. Data were analyzed by SPSS (ver. 17) usingT-test, chi-Square test and logistic regression analysis.
Results: Totally, 429 pregnant women entered the study. There was not a statistically significant difference between morning and shift workers regarding age. It was found that shift work probably increases the incidence of small for gestational age, pre-eclampsia and eclampsia, intra-uterine growth retardation, spontaneous abortion, and preterm delivery, but after adjustment for job and number of children the effect was observed only on preterm delivery.
Conclusion: Working in a rapid cycling schedule of shift work may cause an increase in the incidence of preterm delivery in pregnant mothers.
Objective: Over the past years, the prevalence and the progression rate of HIV infection in Iran especially through high-risk sexual relationships have regrettably been reported at very high levels. This cross-sectional study tries to analyze stigma, mental health, and coping skills on risky behaviors in HIV-positive adults in Tehran- Iran.
Materials and methods: This cross-sectional study was conducted on a sample of 450 HIV-positive adults. Participants completed a socio-demographic questionnaire, the General HealthQuestionnaire-28, the Berger HIV Stigma Scale as well as the Lazarus Ways of Coping Questionnaire (WOCQ). To analyze the data, the independent-samples t-test and Pearson Correlation were used.
Results: The findings of this study revealed that mental health, stigma, and avoidance-escape coping mechanisms were correlated with risky behaviors (p ˂ 0.05).Furthermore, the amount of stigma among female individuals compared to men was reported at higher levels and mental health status in the given group was lower than among male individuals.
Conclusion: It seems that psychological treatment techniques could be effective in improving mental health and reducing risky behaviors.
Objective: To assess and compare the normal ranges of androgen hormones level, total testosterone (TT), free testosterone (FT), dehydrotestosterone (DHT), androstenedione (A4), dehydroepiandrosterone (DHEA), and dehydroepiandrosterone sulfate (DHEAS), in Iranian women based on different statistical methods.
Materials and methods: This study was conducted on previous data collected in Iranian PCOS Prevalence Study, which details have been published before. A total of 1772 women of 18-45 years were recruited from urban areas of five randomly selected provinces in different geographic regions of Iran. The natural range of androgen hormones was determined and compared by two statistical methods including k-means cluster analysis, and receiver operating characteristic curve.
Results: In women younger than 35 years old with any BMI, cut-off points obtained for FAI hormone were in lower percentiles; however, in older women, the results of the two methods were almost the same. Cut-off points of DHEAS in under 35 years old women of normal and obese weight and women older than 35 years old with normal weight calculated by ROC curve method was in higher percentiles than that in the cluster analysis method. In >35 years obese women, obtained cut-off points for DHEAS ROC curve was in lower percentiles in comparison to cluster analysis
Conclusion: Although our study depicts the differences among the cutoff values among two statistical methods; however, lacking a gold standard test to define hyperandrogenism, we need further studies to obtain more comprehensive results.
Objective: To study the effects of the Individual and Group Psycho-educational counseling in pregnant women on knowledge, attitude and mode of delivery.
Materials and methods: This is a randomized controlled trial that carried out on 100 healthy nulliparous pregnant women with uncomplicated pregnancies, who had no contraindication for vaginal birth, but opted for a caesarean section in Medical centers of Dezful city, in the south west of Iran. Participants were randomly assigned into individual or group psycho-educational counseling from gestational week 20 and Knowledge, attitude and mode of delivery in the Individual and Group Psycho-educational counseling methods were measured.
Results: All the participants (100%) in the individual and a majority (92%) in the group counseling changed their preference for birth method to vaginal birth after the counseling intervention. Baseline mean scores of knowledge and attitude into birth method selection were equal between groups. After the counseling intervention the mean scores increased significantly for knowledge in both the individual and group counseling groups: 12.96 and 12.88 before the intervention to 24.16 and 22.62, respectively (p < 0.001). Likewise attitude mean scores increased in both groups: 116.06 and 123.42, respectively, before the counseling sessions, that changed to 170.12 and 160.36 after the counseling sessions
(p < 0.001). The differences in knowledge and attitude mean scores were statistically non-significant between groups after the intervention.
Conclusion: The individual as well as the group psycho-educational counseling sessions increased the knowledge and attitude of pregnant women in relation to vaginal birth without significant differences between groups. Both methods can be recommended. A group counseling method is more effective for advising on the choice of delivery method when many women request a caesarean section without medical indications.
Objective: To evaluate presence of different subtypes and genetic variations of JC virus in different geographical areas is a useful tool for reconstructing of the genetic information and understanding of the evolution of the virus and also in tracing of the last and present history of human immigration.
Materials and methods: This study aimed to investigate the reactivation of different genotypes of JC virus in kidney and its excretion in the urine of the 50 pregnant and 50 non-pregnant women. Phenol-chloroform method was used to extract DNA. Oligo 7 and MEGA 7 software were used for designing nested PCR specific primers based on vp1 capsid gene, and construction of phylogenetic tree, respectively. Fisher’s exact test was used for statistical analyses.
Results: All of the positive samples were sequenced and according to them, genotypes 1 and 3 of the virus were detected for the first time in pregnant and non-pregnant women in Asia. The frequency of genotypes 1 and 3 were 14.28% and 85.71% respectively.
Conclusion: For the first time genotype 3 was reported as the frequent genotype in pregnant women in Asia. Confirming these needs more studies particularly with a higher number of cases and full genome sequencing of isolated JCVs.
A tail-gut cyst can be often a misleading clinical entity. In half of the patients there is no presenting symptom. On the other half, the patients most commonly present with a variety of symptoms such as rectal pain, constipation, lower back pain, dysuria or dyspareunia. The recommended treatment of choice for the tail-gut cyst is complete surgical excision without rupture of the cyst. We present the case of a 29-year-old female with history of dyspareunia over a 5-month period, who discovered an “ovarian” cyst during an annual scheduled ultrasound appointment. However, the intraoperative findings were surprising. The bottomline is always to keep in mind the Pandora’s Box of the retrorectal space.
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