Breastfeeding Needs in Adolescent Mothers: A systematic review

Adolescent mothers face numerous challenges while breastfeeding. The purpose of the study was to assess the breastfeeding needs of adolescent mothers. Two researchers independently searched the databases Web of Science, PubMed, Scopus, Cochrane Library, SID, and Magiran. The initial search yielded 2290 studies, of which 41 were eventually included in this systematic review. Breastfeeding requirements of adolescent mothers were categorized into eight categories: 1. Social support from health care providers, partners, and families; 2. School support for breastfeeding mothers, 3. Receiving breastfeeding counseling based on cultural sensitivities, 4. Educational assistance from health providers for adolescent mothers' families 5. Changing harmful cultural values and judgments about adolescent mothers' breastfeeding, 6. Additional home or outpatient visits in the days following hospital discharge; 7. Peer support and peer counseling, 8. Economic needs.  To promote breastfeeding, policymakers and healthcare providers ought to devise specifically tailored programs and interventions to cater to the specific requirements of mothers. Keywords: Breastfeeding; Adolescent Mothers; Infant Feeding; Need; Qualitative Study

Motor-language links in children with Down syndrome: a scoping review to revisit the literature with a developmental cascades lens

BackgroundChildren with Down syndrome (DS) typically have motor and language needs. Improving function is a shared goal for the rehabilitation therapy team, however physical therapy, occupational therapy, and speech-language pathology professionals treat patients differently. This difference in care may mask developmental cascades whereby changes in one domain (e.g., motor) can have seemingly unexpected effects on another domain (e.g., language).ObjectiveThis scoping review identified papers where motor and language data have been reported together in children with DS and reinterpreted findings from a developmental cascades lens.DesignOnline databases were used to identify 413 papers published before October 2021 from which 33 papers were retained that reported both motor (gross and/or fine) and language (expressive and/or receptive) data in individuals with DS with a chronological age of 0–18 years.ResultsThe majority of papers (79%) that reported motor and language data in children with DS did not examine their link, while 12% analyzed motor-language links, but using a cross-sectional or retrospective design. Only three papers (9%) utilized a longitudinal design to examine predictive links.ConclusionMotor functioning and language functioning have often been reported together, but not analyzed together, in studies of children with DS. The few studies that did analyze motor-language links largely replicated findings from other developmental populations where motor gains were positively linked to language gains. Analyzing links between domains when such data is available is needed to fully characterize developmental cascades in DS and may have broad clinical implications

Effectiveness of Two Types of Photostimulable Phosphor Plate Plastic Barrier Envelopes for Prevention of Microbiological Contamination

Objective: To compare the effectiveness of two types of commercially available photostimulable phosphor plate (PSP) protective barrier envelopes to prevent microbiological contamination. Material and Methods: In this cross-sectional study, 80 barrier envelopes were tested in 40 volunteers. The PSP plates were placed individually in Asia Teb and Soredex protective barrier envelopes and were placed in the mouth for two minutes, similar to periapical films. The protective barrier envelopes were then removed under sterile conditions, and the sensors were placed on different culture media. The number of colonies on each plate was counted. Data were analyzed using SPSS via McNemar and Wilcoxon tests. Results: Bacterial growth was noted in 17.5% of PSPs with Soredex, and 32.5% of PSPs with Asia Teb barrier envelopes. Gram- positive bacilli were the most commonly isolated bacteria. The difference between the Asia Teb and Soredex barrier envelopes for the protection of microbiological contamination was not significant (p>0.05). Conclusion: The use of different types of protective barrier envelopes was not sufficient for prevention of microbiological contamination of PSP plates, and some adjunct modalities were required to decrease microbiological contamination of PSP plates

Internet Addiction Among Iranian Students of Medical Sciences

Objective: To identify the prevalence of Internet addiction (IA) and associated factors among Iranian medical students. Material and Methods: The cross-sectional survey was conducted on a random sample of 400 students. The self-administered questionnaire consisted of two sections: the first section was sociodemographic data, data about student's relations, and Internet use characteristics; the second part aimed at assessment of the level of IA using Young's 20-item scale for IA. Data analyzed in SPSS 20 at 0.05 significant level. Results: Considering their familiarity with the Internet, 80.3% stated personal experience and 12.3% individuals stated educational periods held outside the university. The most locations of using the Internet were dormitories (21.0%) and houses (43.5%). Concerning hours of Internet use, 45.2% used the Internet more than two hours per day. One hundred sixty-eight individuals (42.0%) stated that they used the Internet less than 15% for university activities. One hundred eighty-eight individuals (47.0%) used VPN and 75.5% were dissatisfied with Internet speed 61.2%. A total of 64.3% had a poor dependency on the Internet and the prevalence of IA was 3.5%. The mean score of IA questionnaire was 43.98 ± 15.92 from 125. The mean score of IA was higher in the male sex, but there was no significant correlation between sex and IA (p>0.05). There was not a significant correlation between the field of study and the year of entrance. Conclusion: The prevalence of Internet addiction among medical students was low. Identification of factors associated with IA can help in the planning of preventive programs to raise students’ knowledge about the hazards IA

Association between the dietary inflammatory index and markers of endothelial and systemic inflammation in hemodialysis patients

ObjectivesThe current survey aimed to investigate the link between energy-adjusted dietary inflammatory index (E-DII) and risk factors for CVD including markers of endothelial and systemic inflammation in Iranian hemodialysis patients.MethodsPatients on hemodialysis for at least 6 months prior to enrollment were considered eligible in this cross-sectional study. The usual dietary intakes of the hemodialysis individuals were examined through 4 non-consecutive days including 2 dialysis days and 2 non-dialysis days using a 24-h recall approach to calculate E-DII. Multiple linear regression analysis was utilized to investigate the link between E-DII and selected biomarkers of inflammation and oxidative stress including high-sensitive C reactive protein (hs-CRP), serum intercellular adhesion molecule (sICAM), serum vascular cell adhesion molecule (sVCAM), malondialdehyde, and nitric oxide (NO), sE-selectin, and endothelin-1, and beta (β) and 95% confidence interval (CI) was reported. Value of p < 0.05 was considered statistically significant.ResultsOverall, 291 hemodialysis patients make up our study population. In the crude model, the E-DII score was positively associated with a higher sVCAM-1 (β = 177.39; 95% CI: 60.51, 294.26; ptrend = 0.003). Further adjustment for potential confounders attenuated the findings in a way that an increase of 128.72 in the sVCAM-1 was observed when the E-DII score increased from −2.68 to −1.14 (95% CI: 13.50, 243.94). After controlling for potential confounders, E-DII was associated with sE-selectin in hemodialysis patients in the highest category of E-DII as compared to the lowest category (β = 4.11; 95% CI: 0.22, 8.00; ptrend = 0.039).ConclusionThe present findings suggest that adherence to a pro-inflammatory diet among hemodialysis patients is associated with a higher inflammatory status as evidenced by sVCAM-1 and sE-selectin; however, bidirectionality may exist and the role of residual confounders should be taken into account. Therefore, more longitudinal investigations are needed to elucidate the role of diet on the inflammatory status of hemodialysis patients

Exploring Health Providers’ Perspective Regarding the Needs of Adolescent Mothers During Breastfeeding: A Qualitative Study

Background: The prevalence of breastfeeding is less common among adolescent mothers than adultmothers. These mothers experience various issues during breastfeeding. The present study aimed toexplore the normative needs of adolescent mothers during breastfeeding from health care providers’perspective.Methods: This qualitative content analysis study was conducted from October 2022 until June 2023.14 health care providers who had worked in the field of breast milk were purposefully selected withmaximum variation. Face-to-face semi-structured interviews were conducted and sampling continueduntil data saturation. Data analysis was performed using Graneheim and Lundman’s method withMAXQDA software version 10.Results: The main concepts obtained from the data were classified into one theme entitled,“comprehensive support”, and seven categories including “need to correct wrong traditional beliefs”,“educational and counseling needs”, “providing quality services”, “need for psychological support”,“need for protective laws”, “financial needs”, and “the need for social network support”.Conclusion: Adolescent mothers in Iran have various needs during breastfeeding, and they requirethe assistance of their families, healthcare providers, and the government to fulfill them. Therefore, itis also recommended that policymakers in the health system should design policies to accommodatethe requirements of this group of mothers. In addition to policy development in the health system, theinfrastructure required for policy and law to be executed should be considered

Outcome of Vaginal Progesterone as a Tocolytic Agent: Randomized Clinical Trial

Vaginal progesterone has a potential beneficial effect in postponing of preterm labor by suppression of prostaglandins cascades. Although different studies evaluated the use of progesterone for preterm birth, the exact effect of which on prolongation of pregnancy remains unclear. Seventy two women who underwent preterm labor were managed by magnesium sulfate. Then they were randomly assigned to continue pregnancy either by applying vaginal progesterone (400 mg) until delivery or without using any drug. Gestational age mean at the time of delivery (P = 0.039) and postponing delivery mean time (P = 0.048) were significantly higher in progesterone group. Comparison of neonatal outcomes between two groups of patients showed meaningful benefits of progesterone in increasing of neonatal weight, reduction of low birth weight babies, and lowing neonate admitted in NICU

Coronavirus disease 2019 (COVID-19) manifestations during pregnancy in all three trimesters: A case series

Background: Coronavirus disease 2019 (COVID-19) pandemic has raised concerns about the susceptibility amongst different groups of the population. Pregnant women are one such group. This study was conducted to investigate the effect of COVID-19 on pregnancy and maternal/neonatal outcomes. Case presentation: This case series was conducted on 16 pregnant women with COVID-19 from March 21 to May 11, 2020. Clinical characteristics, pregnancy complications, medication used, maternal/neonatal outcomes, and fatality rate were investigated through this study. The mean age of the patients was 30.06 yrs. Patients from all three trimesters were included (1 in first, 5 in second, and 10 in the third trimesters). The most common clinical symptoms were shortness of breath (n = 10), dry cough (n = 10), myalgia (n = 8), and chills (n = 7). Also, three cases had papulosquamous skin lesions with fissuring. The most common laboratory results were leukocytosis (n = 8), increased liver enzymes (n = 6), elevated CRP (n = 5), and thrombocytopenia (n = 4). There was one case of maternal mortality, five of premature labor pain (PLP), two of preeclampsia, and two of placenta accreta. Twelve pregnancies were terminated (nine cesarean sections, three vaginal deliveries). Among neonates, we had 6 cases of preterm labor. All neonates had negative PCR results. Conclusion: Clinical manifestations and paraclinical results were similar to nonpregnant patients. There was no evidence of vertical transmission. PLP and premature rupture of membranes (PROM) were the most common complications in the second and third trimesters of pregnant COVID-19 women, which can lead to rupture of the uterus. Termination and delivery should be planned individually. Key words: Pregnancy, COVID-19, Maternal-fetal infection transmission, Vertical transmission of infectious disease, Papulosquamous skin diseases

Histopathologic Findings of Olfactory Mucosa in COVID-19 Patients

Background: Olfactory manifestations are common findings during the course of COVID-19, while exact physiopathology is not known Aim: We review histological changes of the nasal olfactory mucosa in COVID-19 non-survivors who died in the ICU. Methods: Sampling was done within 1 hour of death under direct vision. Specimens were taken medial to the middle turbinate in the cribriform area and embedded in paraffin blocks and stained by haematoxylin and eosin. Results: The most frequent histologic finding was the infiltration of inflammatory cells mostly comprised of lymphocytes. Inflammatory infiltration of mucosa was seen in all 11 patients with ulceration in 9 cases and neuritis in 3 cases.  Conclusion: Inflammatory infiltration of olfactory mucosa may be associated with smell manifestations. Further histological studies will clarify the role of the nasal mucosa in the physiopathology of COVID-19 especially olfactory involvement

A review on kinematic parameters in scoliotic patients

Introduction: Scoliosis is one the most common orthopedic problems in children and adults which is still idiopathic. Scoliosis is a three planar deformity and results in changes in anatomy of spine and pelvic that alters gait parameters. The purpose of this study was to evaluate changes in kinematic parameters in lower limb, upper limb, and trunk in scoliosis patients compared with normal subjects. Determining the exact pattern of these changes and the effect of it's severity on this parameters can be used to check the progression or improvement of scoliosis. Materials and Methods: To find and collect suitable articles some key words like scoliosis, gait, and kinematics were used in data bases such as Google Scholar, Pubmed, Elsevier, Ovid and Springer. Papers were selected based on identified inclusion and exclusion criteria. Then articles were scored by Downs and black tool. Results: Among of twenty five articles, 9 articles were selected on basis of inclusion and exclusion criteria from 1998 to 2012. Step length was the only temporospatial parameter that showed a significant reduction. Kinematic parameters in Lower limb identified reduced range of motion, but motion pattern did not show any significant difference. The most differences in data were observed in trunk and pelvic rotation. It was cleared only in person who has a large curvature of the thoracic spine and the same direction of pelvic rotation. Pelvic changes were not predicted in other cases. Pelvic also indicated some changes in x-ray and according to anatomical relation between pelvic and lumbar, thoracolumbar and lumbar curves had the most effect on the pelvic changes. Conclusion: The majority of these articles investigated walking parameters in different speeds. In order to achieve the comprehensive outcomes, the standard model should exist with regarding a curve type and test condition, especially in the upper limb that has been paid low attention, so far. Keywords: Scoliosis, Gait, Kinematics, Lower lim