Comparative study on the effect of combine low dose contraceptive pills administered by the oral and vaginal routes on bleeding pattern in dysfunctional uterine bleeding

چکیده: زمینه و هدف: قرص های جلوگیری از بارداری که عموماً به صورت خوراکی مصرف می شوند عوارض جانبی همچون ایجاد حالت تهوع و استفراغ و افزایش فشار خون دارند. مصرف واژینال این قرص ها باعث کاهش این عوارض می شود. مطالعه حاضر با هدف بررسی مقایسه ای اثر قرص های ضدبارداری با دوز کم (L.D. Contraceptive) در مصرف واژینال و خوراکی در کنترل خونریزی های رحمی ناشی از نقص عملکردی (DUB) انجام شده است. روش بررسی: در این مطالعه کارآزمایی بالینی 100 نفر از زنانی که به علت خونریزی های رحمی ناشی از نقص عملکردی به درمانگاه های بیمارستان های شهید بهشتی و الزهرا(س) اصفهان مراجعه کرده بودند به روش در دسترس انتخاب و به صورت تصادفی در دو گروه درمان با قرص های ضد بارداری با دوز کم از طریق خوراکی و واژینال تقسیم شدند. برای افراد هر دو گروه در ابتدا و انتهای مطالعه مقدار خونریزی و طول مدت خونریزی بر اساس چارت Pictorial bleeding assessment اندازه گیری و عوارض جانبی دارو در انتهای مطالعه در هر دو گروه بررسی و با یکدیگر مقایسه شد. داده ها با استفاده از آزمون آماری کای دو تجزیه و تحلیل گردید. یافته ها: نتایج حاصل از این مطالعه نشان داد که هر دو روش خوراکی و واژینال به طور موثری باعث کاهش مدت زمان و مقدار خونریزی حاصل از نقص عملکردی پس از سه دوره درمانی می شوند، که کاهش مدت زمان خونریزی در روش واژینال به نحو معنی داری از روش خوراکی بیشتر است (05/0

Insulin-like growth factor-1 on cycle day 2 and assisted reproductive techniques outcome: A cross-sectional study

Background: Individualized assisted reproductive techniques (ART) can improve ART outcomes. Some studies suggested using insulin-like growth factor-1 (IGF-1) level on cycle day 2 for individualized ART. Objectives: To investigate the relationship between the serum levels of IGF-1 on day 2 of the cycle and ART outcomes. Materials and Methods: In this cross-sectional study, cycle day 2 serum levels of IGF- 1 were measured in 175 women aged between 18-44 yr as candidates for in vitro fertilization or intracytoplasmic sperm injection. All participants received antagonist protocol, and the relationship between serum levels of IGF-1 and ART outcomes according to the number of oocytes were investigated; poor responders (oocytes < 5), normal responders (oocytes 5-15), and hyper responders (oocytes > 15). Results: Poor responders had higher serum level of IGF-1 when compared with normal and hyper-responders; however, this difference was not statistically significant (p = 0.41). The serum levels of IGF-1 in women with zero retrieved oocytes and those cycles that were canceled for the inappropriate ovarian response were not significantly different compared to other women in the group of poor responders. An inverse relationship was observed between the serum level of IGF-1 and anti-Mullerian hormone levels. Furthermore, no significant relationship between serum level of IGF-1 with age, body mass index, number of 2 pronucleus, and number of embryos was observed. Conclusions: According to our results, the serum levels of IGF-1 may not be able to predict ART outcomes. It seems necessary to conduct more studies with larger sample size in this field. Key words: Insulin-like growth factor-1, Poor ovarian response, Oocyte retrieval, Assisted reproductive technique outcome

Correlation between workplace culture, learning and medication errors

The occurrence of medication errors in intensivecare units can bring about irreparable damageand even lead to death in hospitalized patients.In this respect, numerous investigations have suggestedthat many factors including workplace culture and learningfrom error can affect the incidence rates of such errorsin these units. Accordingly, the present study was to shedlight on the correlation between workplace culture, learningfrom error, and reporting rate of medication errorsamong nurses in intensive care units affiliated to teachinghospitals of Shahid Beheshti University of Medical Sciencesin Iran.Methods: A descriptive-analytical study was conductedamong 120 nurses working in intensive care units in fourteaching hospitals in the city of Tehran. Then, the questionnairesdeveloped by Gulley et al., Rybowiak et al., andWakefield et al. were used to collect the data related toworkplace culture, learning climate, and medication errors.Results: The findings of this study indicated that increasedlearning from error in nurses working in intensivecare units could lower reporting rate of medication errors(r=-0.312, p-value=0.001); there was also a significantrelationship between workplace culture and reportingrate of medication errors, so that enhancing workplaceculture could reduce reporting rate of medication errors(r=-0.239, p-value=0.012).Conclusion: Improving workplace culture via supportingemployee creativity and innovation as well as promotinglearning environment through an employee reward systemalong with avoidance of punishments and reprimands fornurses during the occurrence of errors could be effective inmitigating the incidence rates of medication errors

The Views of Faculty Members and Basic Sciences Medical Students on the Students’ Teacher Evaluations in Islamic Azad University, Tehran Medical Sciences Branch, Iran

Background and Objectives: Teacher evaluation is among the most influential methods of quality assurance and is essential to continuous quality improvement in education systems. The current study aims to evaluate the views of faculty members and basic sciences medical students on the evaluation of teachers by students in the Islamic Azad University, Tehran Medical Sciences Branch, Tehran, Iran. Methods: The current descriptive analytical study was conducted in the faculty of medical sciences during the winter of 2015. The census sampling method was used to select the participants and 335 students and 35 faculty members were enrolled accordingly, of which 300 students (89.5%) and 33 faculty members (94.2%) completed the study. The data collection instrument used was a 20-item questionnaire (created by the researcher) scored on a 5-option Likert scale. The formal validity, content validity, content validity ratio (CVR), content validity index (CVI), and the structural validity of the questionnaire were confirmed using exploratory factor analysis. Its validity was measured by the Cronbach’s alpha. Data were analyzed with SPSS using t test. Results: It was found that the lecturer’s popularity, students’ grades, and the research evidence provided by the lecturer in the classroom were the most important factors, while gender and course type were the least important factors influencing students’ evaluation of lecturers in the current study. The mean scores of students and lecturers regarding their views on the teacher evaluation system were 79.14 ± 11.89 and 78.00 ± 8.15 respectively. According to the results of an independent t test, no significant difference was observed between the scores of lecturers and students regarding their views on the teacher evaluation system (P > 0.01). Conclusions: The questionnaire created by the researcher showed good validity and reliability to evaluate the views of facultymembers and students on the teacher evaluation system. The lecturer’s popularity, students’ grades, and the research evidence provided by the lecturer were considered as the most important factors, while gender and course type were the least important factors influencing the teachers’ evaluation, based on the comments of the faculty members and students. Keywords: Evaluation of Professors, Influencing Factors, Students, Faculty Member

Risk factors of metastasis in women with breast cancer in Isfahan, Iran

Background: Breast cancer is one of the most common malignancies in women and its metastasis plays an important role in mortality, treatment failures and complications. The objective of this study was to evaluate the risk factors of metastatic breast cancer. Methods: In a retrospective cohort study, breast cancer patients in Isfahan, Iran were followed up for ten years. The existence of metastasis was considered as the dependent variable while independent variables included age at diagnosis, hormone receptor status, family history, number of lymph nodes dissected in surgery and involved ones, number of pregnancies, age at first pregnancy and menarche, menstrual status, histopathology and tumor size. All data was collected from patients' profiles and analyzed using logistic regression in SPSS16. Findings: A total of 685 patients with breast cancer were studied during 1999-2009. While 91.4 of cases had no metastasis, distant metastasis was found in 8.6 of subjects. Sites of metastasis according to prevalence were lung (4.7), bone (2.6), other organs (1.1), and liver (0.3). Number of involved lymph nodes (P = 0.043) and number of pregnancies (P = 0.022) had significant relationships with metastasis. Conclusion: We concluded that less pregnancies and more involved lymph nodes indicate a high probability of metastasis occurrence. Therefore, survival improvement might be possible with early diagnosis of breast cancer, using prophylactic treatments, and identifying metastatic cases by diagnostic tests

Myo-inositol effect on pregnancy outcomes in infertile women undergoing in vitro fertilization/intracytoplasmic sperm injection: A double-blind RCT

Background: Myo-inositol is an intracellular mediator which is involved in various aspects of reproduction in women. Objective: This study aimed to evaluate the impact of Myo-inositol on the outcomes of in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles in infertile women. Materials and Methods: This double-blind randomized controlled trial was conducted on 70 infertile women referred to the Infertility Treatment Center, Besat hospital, Sanandaj, Iran from May 2019 to September 2019 for IVF/ICSI cycles. The participants were randomly divided into 2 intervention (n = 36) and control (n = 34) groups. The intervention group received 2000 mg of Myo-inositol and 200 mcg folic acid twice a day for 2 months and the control group received 200 mcg of folic acid twice a day for 2 months in the IVF/ICSI cycles (from the third day of cycle until the end of the second month). Finally, the number of oocytes, the quality of embryos, and the IVF/ICSI outcomes were compared between the 2 groups. Results: The mean numbers of oocytes, MII oocytes, and 2 pronuclear embryos were significantly higher in the intervention group than the control group. Also, the clinical pregnancy and live birth rates in the intervention group were significantly higher than in the controls (p = 0.04). Conclusion: The administration of Myo-inositol may increase clinical pregnancy and live birth rates by increasing the number of total and meiosis II oocytes in infertile women undergoing IVF/ICSI. Key words: Infertility, In vitro fertilization, Intracytoplasmic sperm injection, Myoinositol

Problems of Continuing Medical Education Programs and Their Solutions from the Viewpoint of Faculty Members

Background & Objective: The majority of surveys have demonstrated the inadequate success rate of continuing education programs in Iran from the viewpoint of participants. However, no studies have been conducted on the viewpoints of lecturers (influential individuals and beneficiaries in this issue) in this regard. Thus, the present study aimed to investigate the problems of continuing education programs and their solutions from the perspective of lecturers. Methods: This qualitative study was conducted in 2015 on 15 university faculty members who had previous experience of lecturing continuing education programs. The participants were selected using purposive sampling (n = 15). Data were gathered through focus group discussion. All discussions were recorded on audiotapes, transcribed, and then, analyzed through inductive content analysis. Results: Data analysis led to the extraction of 3 main themes (problems), 12 categories, 42 subcategories, and 68 suggested solutions. The main themes included the reduction of incentive to participate in programs (4 categories), low effectiveness of implemented programs (5 categories), and the ineffective evaluation of programs (3 categories). Conclusion: The main motivation for general practitioners to participate in these programs must be the correction of professional practice. It seems that intervention in the implementation and assessment fields are more likely than participants’ motivation. Providing teaching methods workshops for faculty members, improving awareness of the goals and timetable of workshops, holding workshops rather than lectures, evaluating performance instead of satisfaction, and providing feedback on the assessment results are effective factors in the efficiency of programs. Key Words: Effectiveness, Continuing education, General practitioner, Evaluation, Qualitative stud

Screening performance of Ultrasonographic B-lines in Detection of Lung Contusion following Blunt Trauma; a Diagnostic Accuracy Study

Introduction: Chest ultrasonography is routinely used in evaluation of chest trauma for diagnosis of pulmonary injury. This study aimed to evaluate the accuracy of B-Lines for diagnosing lung contusion in patients with blunt trauma of the chest. Methods: Trauma patients who met the inclusion criteria were enrolled in the study and underwent ultrasonography by trained emergency medicine residents. Ultrasound results were recorded in terms of number of B-lines and the existence of peripheral parenchymal lesion (PPL). After ultrasound, the patient underwent chest x-ray and chest CT scan (as reference test) and screening performance of B-lines and PPL were evaluated.Results: 147 patients underwent chest ultrasound. The mean age of the patients was 40.74 ± 18.6 (78.9% male). B-lines˃3 had 94.0% (95% CI: 83.45-98.75) sensitivity and 57.7% (95% CI: 47.3-67.7) specificity, B-lines˃6 had 90.0% (95% CI: 78.2-96.7) sensitivity and 93.81% (95% CI: 87.0-97.7) specificity, and PPL had 34.0% (95% CI: 21.2-48.8) sensitivity and 100% (95% CI: 96.3-100.0) specificity. Composite findings of B-lines˃6 + PPL had 92.0% (95% CI: 80.8-97. 8) sensitivity and 93.8% (95% CI: 87.0-97.7) specificity in the diagnosis of lung contusion.Conclusion: PPL and B-Lines˃6 had the highest accuracy in detecting lung contusion. B-Line˃6 had high sensitivity and specificity and was easy to perform; thus, it seems that B-Line˃6 could be considered as an alternative screening tool in detection of lung contusion

In vivo antioxidant activity of Zataria multiflora Boiss essential oil

Zataria multiflora Boiss. (Lamiaceae) is an endemic plant to Iran with many traditional uses. We have reported previously in vitro antioxidant activity of the essential oil of the plant. In the present work we aimed to evaluate the antioxidant activity of the oil in rat. Antioxidant activity was measured by the test of 1,1-diphenyl-2- picrylhydrazyl (DPPH) radical inhibition and inhibition of lipid peroxidation by measuring the index of thiobarbituric acid reactive substances (TBARs). Three doses of 100, 200 and 400 μL/ kg of the essential oil of Z. multiflora (ZMO) was administered to animals by i.g routh for 10 days. The blood was collected in 11th day through direct puncture and the liver was rapidly excised. The histopathology studies of the animals was compared to animals in butylated hydroxyl toluene (BHT) group. The results showed that ZMO in all tested doses significantly was able to scavenge DPPH radical (p<0.05). ZMO also decreased TBARs in a dose dependent manner. No alteration in LFT enzymes or changes in histopathology of the liver was considered in ZMO treated groups. The results indicated that ZMO might be used in healthy medicine and food industry