Global prevalence of urinary tract infection in pregnant mothers: a systematic review and meta-analysis

OBJECTIVE

Urinary tract infection (UTI) is a prevalent infection during pregnancy that can lead to complications for both the mother and the foetus. The objective of this systematic review and meta-analysis is to determine the global prevalence of UTIs (both symptomatic and asymptomatic) during pregnancy, based on previous studies in this area. Furthermore, this study aims to identify any factors that contribute to heterogeneity in the prevalence of UTIs during pregnancy.

STUDY DESIGN

Systematic review and meta-analysis.

METHODS

This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines on August 8, 2022. To conduct the systematic review and meta-analysis, a search was performed using the keywords "urinary tract system", "UTI", "pregnancy", and "gestation" was performed in several databases, including Web of Science (WoS), PubMed, Scopus, ScienceDirect, Embase, and Google Scholar, without a time limit until September 18, 2022. The analysis was performed using a random-effects model, and the heterogeneity of the studies was assessed using the I2 index. The Comprehensive Meta-Analysis software (Version 2) was used for data analysis.

RESULTS

The systematic review and meta-analysis of 27 studies, which included a total of 30,641 pregnant women, showed an overall prevalence of UTI (both symptomatic and asymptomatic) to be 23.9% (95% confidence interval: 16.2-33.8). Meta-regression analysis was conducted to examine the impact of two factors, namely study sample size and study year, on the heterogeneity of the meta-analysis. The results revealed that an increase in sample size, and the study year was associated with a decrease in the prevalence of UTI in pregnant women (P < 0.05).

CONCLUSION

The results of our study indicate a global prevalence of UTI in pregnant women to be 23.9%. Therefore, it is recommended that all pregnant women undergo regular UTI screening tests and receive prompt treatment if diagnosed with UTI. Early detection and treatment of UTI during pregnancy are crucial to prevent complications that may affect the health of both the mother and the foetus.

The Modified Hospital Elder Life Program (HELP) in geriatric hospitalized patients in internal wards: A double-blind randomized control trial

Background

Hospital Elder Life Program (HELP) provides protocols based on factors for reducing delirium. Due to the lack of geriatric wards and aged care teams in Iran, it seems that some of the original HELP interventions need to be modified through a trial study. Hence, this study was conducted to determine whether the Iranian modified HELP could reduce delirium in geriatric hospitalized patients.

Methods

This double-blind randomized controlled trial was designed and conducted in a hospital at Kashan University of Medical Sciences in Iran. A total of 195 hospitalized patients aged ≥70 years, were 84 in the Intervention Group (IG) and 111 in the Control Group (CG). After assessing delirium risk factors, participants in the IG group received interventions based on the cognitive, vision/hearing, sleep, mobility, feeding, and hydration protocols by nursing students and the CG group received routine care.

Delirium incidence was assessed by the Confusion Assessment Method. Delirium incidence, cognitive and functional abilities, frailty, fall, and length of stay were outcomes.

Results

The mean age of the patients was 78.53(Standard Deviation = 5.87) years. Delirium incidence was higher in the CG comparing to IG (14.71% vs 3.66%).Significant reduction observed in risk incidence of delirium because of interventions [Odds Ratio:0.124, Confidence Interval: 0.03–0.48].

Conclusion

The modified HELP effectively reduced delirium rates in geriatric hospitalized patients.

Trial registration

This study was registered at the Iranian Registry of Clinical Trials IRCT20180910040995N1.

Extracellular Vesicles in Acute Leukemia: A Mesmerizing Journey With a Focus on Transferred microRNAs

Despite their small size, the membrane-bound particles named extracellular vesicles (EVs) seem to play an enormous role in the pathogenesis of acute leukemia. From oncogenic hematopoietic stem cells (HSCs) to become leukemic cells to alter the architecture of bone marrow (BM) microenvironment, EVs are critical components of leukemia development. As a carrier of essential molecules, especially a group of small non-coding RNAs known as miRNA, recently, EVs have attracted tremendous attention as a prognostic factor. Given the importance of miRNAs in the early stages of leukemogenesis and also their critical parts in the development of drug-resistant phenotype, it seems that the importance of EVs in the development of leukemia is more than what is expected. To be familiar with the clinical value of leukemia-derived EVs, this review aimed to briefly shed light on the biology of EVs and to discuss the role of EV-derived miRNAs in the development of acute myeloid leukemia and acute lymphoblastic leukemia. By elaborating the advances and challenges concerning the isolation of EVs, we discuss whether EVs could have a prognostic value in the clinical setting for leukemia.

Assessing the performance of remotely sensed landscape function indices in semi-arid rangelands of Iran

Appropriate rangeland management requires rangeland function analysis at broad scales. This study aimed to examine the potential of remotely sensed function indices extracted from Landsat data to evaluate the function of semi-arid rangelands in central Iran at the sub-basin scale. Three replicate 30-m transects were randomly placed in the dominant slope direction of 14 selected sub-basins. Various structural properties of vegetation (e.g. number and size of vegetation patches and interpatch lengths) and soil surface were scored based on the landscape function analysis (LFA) procedure. The obtained structural and function indices of the LFA, as well as field percent vegetation cover, were compared with the perpendicular distance vegetation index and remotely sensed function indices including proximity, lacunarity, leakiness index, and weighted mean patch size (WMPS). Remotely sensed function indices were found to be capable of discriminating rangeland landscapes with different conditions. Results showed that the structural properties of vegetation considered in the LFA could also be obtained through WMPS and proximity indices (R >0.76; P < 0.01). All indices, except for lacunarity, had significant correlations with percent vegetation cover and the strongest correlation was observed between WMPS and proximity. Our findings highlight the usefulness and efficiency of function indices derived from satellite data in the estimation of structural and functional properties of rangeland landscapes at the sub-basin scale.

Marital satisfaction and adherence to religion

Background: One of the most important determinants of health and marital satisfaction, the family and religious adherence can be effective because religion includes guidelines for life and providing a system of beliefs and values make these features can affect family life. Approach: This descriptive research - an analysis performed to assess the level of satisfaction of 47 questionnaires marital satisfaction questionnaire whose validity and reliability were evaluated and a couple of them asked to assess adherence to religion. The study population included 382 couples in Tehran that a cluster of 22 districts of Tehran were the selected. To analyze the data, ANOVA, Chi-square, and Pearson correlation coefficient using the software SPSS (version 22) became all tests were performed at the 5% level. Results: The data showed that the average age is 34 for women and 38 years for men and the majority of couples are in appropriate level in religiosity (40.5 percent). The results showed a main direct relation among religiosity and marital satisfaction of men and women (p ≤ 0.001). The correlation among religiosity and marital satisfaction of women r = 0.271 and this factor in men r = 0.200 was obtained indicating a direct relationship was significant. Conclusion: couples who were both committed to religion, their marital satisfaction score was more than couples without adherence to religion, and thus promoting religious beliefs and commitment can increase their marital satisfaction in couples.

Comparison of depression, anxiety, quality of life, vitality and mental health between premenopausal and postmenopausal women

OBJECTIVE

The purpose of this research was to investigate and compare the rates of depression, anxiety, quality of life, vitality and mental health between premenopausal and postmenopausal women.

METHOD

The sample included 218 women selected randomly from the cultural center of Tehran in November and December 2013 and was divided into two groups. The first group included 110 postmenopausal women (45-55 years old). One year had passed since their last monthly period and they had not used any hormones. The second group included 108 premenopausal women (35-45 years old) who had not yet experienced menopause. In order to assess data, three tests were used: the Zung Anxiety Self-Report scale, the Beck Depression Inventory and the Quality of Life questionnaire (SF-36). The gathered data were analyzed with the T-test for independent groups.

RESULTS

The results indicated that all five hypotheses were confirmed. There were significant differences between the scores of anxiety, depression, quality of life, vitality and mental health between the two groups.

CONCLUSION

Since menopausal women spend almost one-third of their long life in this situation, it can be useful to recognize the causes of these disorders in women and their influences on their families. We can also increase their motivation and self-efficacy in order to improve their quality of life.

Effects of Papaver rhoeas (L.) extract on formalin-induced pain and inflammation in mice

Stress amelioration can improve its metabolic as well as other side effects. In the present study, the effects of hydro-alcoholic extract of Papver rhoeas (L.) on formalin-induced pain and inflammation were investigated in male Swiss-Webster mice (20-25 g). Formalin injects in the plantar portion of mice hind paw and pain was studied for 60 min. The plant extract and other drugs were administered intraperitoneally 30 min before formalin. Experiments showed that administration of extract (25, 50 and 100 mg kg(-1)) could induced analgesia in a dose-response manner in both phases of formalin test. More over, the extract inhibits inflammation induced by formalin injection. Naloxone (4 mg kg(-1)), dextromethorphan (20 mg kg(-1)) and NG-nitro-L-arginine-methylester (L-NAME; 10 mg kg(-1)) reduced the extract analgesia in first but not late phase. Extract administration also increased plasma corticosterone level in dose-dependent manner. It could be concluded that Papaver rhoeas (L.) extract could inhibits acute phase of formalin test in mice by opioidergic, glutamatergic and nitricergic mechanisms. In addition, the extract can induce corticosterone plasma level which may be responsible for inhibition of inflammation and chronic phase of pain induced by formalin.

Survey of special needs in elderly people: a qualitative research

The only way for going to rehabilitation and social participation expansion in elderly people is the identification of their special needs in a scientific and accurate way. This study conducted in order to identify the special needs in elderly people.

This article is a part of a qualitative research with grounded theory method. 15 elderly of Tehran city that were selected through a purposeful sampling participated in study. The main method for collecting data was semi-structured interview that continued until theoretical saturation of information. Data was analyzed with Strauss & Corbin coding manner or continued comparison and the assessor’s viewpoints method is used for validity promotion of data. Totally, most important domains of special needs in aging group were: family and relatives, education, movement and transportation, building and places (houses and public places), social participation and occupation, amusement, health and treatment services, and people’s attitude toward their problems.

Those elderly people's special needs that are disabling are often caused by their characteristics and obstacles which are created by society. Therefore, resolving these man-made barriers such as non efficient systems and services, discriminatory policies, prejudice attitudes, etc will help them in the field of rehabilitation and individual independence enhancement.

Survey of special needs in physically disabled people: A qualitative research

After sanction of “the rights of disabled people convention” United Nations Organization have been stressed more on dealing with this group’s needs. Therewith, most of countries in the world have been committed in this field. Therefore with consideration of importance of identifying the needs in disabled people and making policies for them, this study conducted in order to identify the special needs in physically disabled people. This article is a part of a qualitative research with grounded theory method. 15 physically disabled people of Tehran were selected through a purposeful sampling participated in study. The main method for collecting data was semi-structured interview that continued until theoretical saturation of information. Data was analyzed with Strauss & Corbin coding manner or continued comparison and the assessor’s viewpoints method is used for validity promotion of data.

Totally, most important domains of special needs in disabled group were: family and relatives, education, movement and transportation, building and places (houses and public places), social participation and occupation, treatment and rehabilitation services, and people’s attitude toward their problems.

The results indicated that for promoting social participation and function independency in disabled people, should be emphasis on “equality of opportunities” in society rather than “disability”. Thus, public systems and services should be available equally for all, such as physical environments and places, housing, transport system, educational and vocational opportunities, and socio-cultural life like equipments for sport and amusement. Then, physically disabled people can reach to a life with more quality and same with others.

Prevalence and associated factors of persistent diarrhoea in Iranian children admitted to a paediatric hospital

To identify the frequency and associated factors of persistent diarrhoea in a paediatric hospital in Tehran, Islamic Republic of Iran, children admitted with acute diarrhoea were followed prospectively until resolution of the episode. Persistent diarrhoea developed in 19.6% of the 424 diarrhoea cases. Children with persistent diarrhoea were significantly younger than those with acute diarrhoea (15.3 versus 29.4 months). Enteroaggregative Escherichia coli was the most prevalent pathogen in both groups, but otherwise the profile of symptoms and isolated organisms was similar in the 2 groups. History of dietary change prior to admission and use of antibiotics and anticholinergic drugs in the acute phase were significantly higher in the persistent than acute diarrhoea cases.

Does group prenatal care affect satisfaction and prenatal care utilization in Iranian pregnant women?

BACKGROUND

The need to provide high quality prenatal care services, which take account of women's views and specifically address their need for information, support and communication, has been advocated and group prenatal care, had been suggested as one of the ways to achieve this objective. The purpose of this study was to examine the impact of group versus individual prenatal care on satisfaction and prenatal care use.

METHODS

This was a cluster-randomized controlled trial with the health center as the randomization unit that conducted in 2007. Satisfaction was measured through a standardized questionnaire, and the Kotelchuck Adequacy of Prenatal Care Utilization Index was used to measure prenatal care utilization.

RESULTS

We recruited 678 women (group prenatal care, (N= 344) and individual prenatal care, (N=334) in the study. Women in group prenatal care model were more satisfied than women in individual prenatal care model in all areas evaluated, including information, communication, co-ordination and quality of care. Group care women were significantly more likely to have adequate prenatal care than individual care women were (OR=1.35 95% CI=1.26-1.44).

CONCLUSIONS

Group prenatal care was associated with a significant improvement in client satisfaction and prenatal care utilization. This model of care has implications for the planning and provision of prenatal services within public health system, which is moving toward a better quality health care, and increasing use of services.

Socio-economic and medical determinants of low birth weight in Iran: 20 years after establishment of a primary healthcare network

OBJECTIVE

Establishment of a primary healthcare network in Iran has provided free and universal access to primary health care. Although the health status of Iranians has improved since this network was established, the low-birthweight rate has not decreased. The objective of the present study was to describe socio-economic and medical factors related to low birth weight in the context of free and universal access to primary health care.

DESIGN

Descriptive, hospital-based prospective study.

METHODS

Data about socio-economic, reproductive and prenatal condition of 4510 live singleton births from June to October 2004 were gathered using a standard questionnaire by interview and record review. The effect of these conditions on birth weight was investigated using a logistic regression model.

RESULTS

Of 4510 newborns, 305 (6.8%) were low birth weight. Among these low-birthweight newborns, there were 159 preterm and 146 term newborns. Mothers with a primary and secondary education [odds ratio (OR) 6.83, 95% confidence interval (CI) 2.35-7.34 and OR 4.81, 95%CI 1.95-6.37, respectively], who lived with farmer and unskilled worker husbands (OR 2.52, 95%CI 1.12-4.66 and OR 2.91, 95%CI 1.35-2.52, respectively), with a birth interval of 1 year or less (OR 3.54, 95%CI 1.80-5.95) and height less than 155cm (OR 1.82, 95%CI 1.12-3.31) were more likely to have low-birthweight infants.

CONCLUSION

In the context of free and universal access to health care, it is recommended that policy makers should place more emphasis on education as it imparts knowledge and thus influences dietary habits and birth-spacing behaviour. This will lead to a better nutritional status, particularly in dealing with pregnancy, resulting in lower rates of low birth weight.

Densitometric evaluation of skull and jaw bones after administration of thyroid hormones in rats

OBJECTIVES

An investigation was performed by use of optical densitometry to observe the effects of different doses of thyroid hormone on bone density of skull and jaw bones and to evaluate the relationship between T3, T4, thyroid stimulating hormone (TSH) serum levels and bone density.

METHODS

40 Sprague-Dawley rats were randomly divided into four groups with 10 rats in each (a control group that received 10 ml kg(-1) i.p. per day normal saline and three levothyroxine groups that received 5, 10, or 20 microg kg(-1) i.p. per day levothyroxine, respectively). Radiographs were taken of their skulls on days 3 and 16. At the end of the experimental period blood was drawn by intracardiac puncture and serum was analysed for thyroid hormones (T3 and T4) and TSH level. After that, optical density measurements were made on the radiographs of four selected points on the skull and jaw with a digital densitometer. Density measurements were analysed using the student's t-test, one way analysis of variance, Spearman correlation analysis and regression analysis.

RESULTS

Levothyroxine administration reduced bone density (P < or = 0.05) and increasing the dose of thyroid hormone produced a significant decrease of bone density (P < or = 0.05). The mandible was more susceptible to density changes compared with hard palate, skull and alveolar bone (P < or = 0.05).

CONCLUSIONS

Radiographs of the mandible can be utilized to characterize loss of bone density elsewhere. In addition this investigation indicated that optical densitometry is an inexpensive and low risk method for studying bone density.

The effect of thyroid hormone on orthodontic tooth movement in rats

The major goals of this study were to determine the effects of different doses of thyroxin on the rate of orthodontic tooth movement and the force-induced root resorption. In this study fifty male Sprague--Dawley rats were divided into five groups: a normal group with no intervention; a control group in which appliances were placed and 10 ml/kg i.p./day normal saline was injected; and three thyroxin groups in which appliances were placed and 5, 10 and 20/microgram/kg i.p./day L-thyroxin were administered, respectively. A fixed orthodontic appliance consisting of a 5 mm closed-coil spring was ligated between the maxillary incisor and maxillary first molar to deliver an initial force of 60 gm. The results showed that administration of 20/microgram/kg i.p./day L-thyroxin significantly increased the amount of orthodontic tooth movement (p < 0.001). The extent of root resorption as seen from scanning electron micrographs decreased with thyroxin administration.

Differentiation of hepatic cavernous hemangioma from metastases by rare sequence MR imaging

In this study, in order to differentiate cavernous hemangioma and hepatic metastases, rapid acquisition relaxation enhanced (RARE) sequence was used. First, in vivo measurements of T1, T2 relaxation times and proton density were obtained using T1, T2 calculation protocol (TOMIKON S50, 0.5T) and multipoint techniques. These measurements were made from regions of interest placed over the liver, spleen (because of similarity of relaxation time values between hepatic metastases and spleen) and cavernous hemangioma (HCH). Based on these intrinsic parameters, T2 curves signal intensity of three different tissues were constructed. At TE = 500 ms, the signal intensity of the liver and spleen has been near zero whereas in HCH, the signal intensity remained. As RARE sequence is very similar to spin echo (SE), by replacing effective TE(ETE) = 500 ms in the RARE equation, two dimensional contrast-to-noise ratio (CNR) contour plots were constructed demonstrating signal intensity contrast between liver-spleen, liver-Hemangioma for two different scan times (3 min, 7.5 s) and pulse timing. Then, optimal RARE factor and inter echo times were obtained in order to have maximum CNR between liver-Hemangioma and minimum CNR between liver-spleen. These optimal parameters were performed on ten normal and five persons with known HCH. Images showed that in both scan times (3 min, 7.5 s); the liver and spleen were suppressed whereas the HCH was enhanced. The image quality in the scan time of 3 min was better than the scan time of 7.5 s. Moreover, in this study, two different sequences were compared: i) Multi-slice single echo (MSSE) for T1 weighted image ii) RARE (ETE = 80 ms) for T2-weighted image. This comparison was done to show maximum CNR between liver-spleen (metastases) and to choose a better sequence for detecting metastases. CNR in the RARE sequence was more than in the MSSE sequence.

Thermal modeling in cylindrical coordinates using effective conductivity

Predictive thermometry, utilizing minimally invasive sampling techniques, is an essential ingredient in the development of hyperthermia treatment planning capabilities. The authors demonstrate a powerful, but simple approach toward predicting temperature distributions in tissues, based on analytic solution, using in cylindrical symmetry, of the heat diffusion equation. Conduction and localized perfusion effects are combined as an effective conductivity term, readily measurable, and parametrized in a general exponential form. The proposed approach allows a first-order approximation to modeling three typical situations: hypoxic or necrotic tumor core with homogeneously perfused periphery; highly perfused periphery (in rapidly growing tumors); or perfused central cover with a less well-supplied periphery (such as for some invasive tumors). The utility and strength of this approach is that it provides a rapid, accurate model of directly observing the technical quality to be expected for different heating methods, making it possible to optimally configure source distributions in a treatment planning setting.

Heating patterns produced by 434 MHz erbotherm UHF 69

Thermal distributions of 434 MHz Erbotherm H 69 hyperthermia/diathermy generators in tissue-equivalent medium have been investigated. Thermocouples were used to measure temperatures at a set of grid points. Cylindrical and abdominal phantoms were heated and sectioned after heating to measure the temperatures at depth. Results indicate that there is potential for heating deep-seated tumors. The distributions were influenced by the number, shape and geometry of the applicators employed.