The Obstacles of Choosing Vaginal Delivery and Policies to Increase it from the Point of View of Gynecologists and Midwives

Background: In the last few years, the rate of cesarean section has increased all around the world. This study was conducted to investigate the obstacles of performing vaginal delivery and policies to increase vaginal delivery from the point of view of gynecologists and midwives. Methods: A total of one hundred gynecologists and midwives working in Kerman participated in this cross-sectional study. Data were collected using a questionnaire included three parts of demographic data, 13 questions regarding obstacles of normal vaginal delivery (NVD) and 10 questions regarding policies to encourage NVD. Data were analyzed using Mann-Whitney test and through SPSS19 software. Results: There was no significant difference between gynecologists and midwives in regard to mean scores of NVD obstacles and policies to encourage NVD. Among the obstacles, increase of maternal age in the first pregnancy and being afraid of delivery complications obtained the highest and the lowest mean scores respectively .Among the policies to encourage NVD, careful prenatal care had the highest mean score and increasing the cooperation between doctors and midwives had the lowest mean score. Conclusion: According to the results, the most important obstacle of NVD is high maternal age in the first pregnancy and the best recommended solution to encourage NVD is careful prenatal care leading to mothers' preparation for NVD

Evaluation of the Success Rate of Vaginal Delivery and its Related Factors among Women with a History of Infertility in Afzalipour Hospital, Kerman

Background: C-sections are done for various reasons. The history of infertility as one of the reasons for C-section is a controversial issue. The aim of this study was to evaluate the success rate of vaginal delivery and its related factors among pregnant women with an infertility history. Methods: In this cross-sectional study, all women with an infertility history who became pregnant spontaneously, using drugs or assisted reproductive techniques (ART) and were referred to Afzalipour Hospital for delivery during October 2013- October 2014, were selected through census method. Data were collected from patients’ records and, if necessary, obtained by calling the patients. Data were analyzed using SPSS 19, t-test, and chi-square test. Results: All women with infertility history (n=102) during the mentioned time frame were included in this study. Most of them were 20-30 years old with primary infertility (1-3 years infertility) who became pregnant spontaneously. Among them, 61.8% had vaginal delivery. Primary infertility, age less than 30 years, spontaneous pregnancy, and duration of infertility less than 3 years were significantly high in vaginal deliveries. The mean age of women who had C-section was significantly higher than those who had vaginal delivery (P<0.001). Conclusion: In most cases, pregnant women with an infertility history had a successful vaginal delivery and an infertility history was not the only reason for C-section

A Concurrent Dual-Band Inverter-Based Low Noise Amplifier (LNA) for WLAN Applications

low noise amplifier (LNA); concurrent; dual-band; inverter-basedIn this paper, a two-stage concurrent dual-band low noise amplifier (DB-LNA) operating at 2.4/5.2-GHz is presented for Wireless Local Area Network (WLAN) applications. The current-reused structure using resistive shunt-shunt feedback is employed to reduce power dissipation and achieve a wide frequency band from DC to-5.5-GHz in the inverter-based LNA. The second inverter-based stage is employed to increase the gain and obtain a flat gain over the frequency band. An LC network is also inserted at the proposed circuit output to shape the dual-band frequency response. The proposed concurrent DB-LNA is designed by RF-TSMC 0.18-µm CMOS technology, which consumes 10.8 mW from a power supply of 1.5 V. The simulation results show that the proposed DB-LNA achieves a direct power gain (S 21 ) of 13.7/14.1 dB, a noise figure (NF) of 4.2/4.6 dB, and an input return loss (S 11 ) of −12.9/−14.6 dBm at the 2.4/5.2-GHz bands

Factors Associated with the Incidence of Medication Errors and Nurses' Refusal to Error Reporting

Introduction:Medication errors may occur at every stage of the medicines prescription and distribution processes and as nurses can give more than 150 medicines to patients in one work shift, they are in the first line of medical errors. This study was done to investigate the factors associated with nurses' refusal to error reporting in one of the largest teaching hospitals affiliated to Mashhad University of Medical Sciences. Method:In this cross – sectional, descriptive analytic study, a medication errors questionnaire containing 66 questions was distributed among 100 nurses in different hospital departments which were selected by stratified and simple random sampling. Descriptive statistics was used to determine the most important occurred errors and the reasons for them and one way ANOVA and independent t-test were used to determine the relationship of the causes of medication errors and refusal to error reporting with nurses' demographic factors. Data were analyzed through SPSS18 software. Results:According to the obtained findings, 87.6% of nurses were female, 85.9% were married and 47.1% were circulating nurses. “Giving medicines to the patients earlier or later than the prescribed time" was the most occurred error (48.8%). "Fear of getting involved with law enforcement," was the most important cause of refusal to error reporting (3.48±1.53) and "heavy workload" was the main reason of error occurrence (4.18±1.1). Conclusion:Medication errors, however minor, can cause complications. To reduce medication errors, re-education classes in relation to pharmacological information, encouragement of nurses to report medical errors and positive reaction of head nurses are required. Key¬words:Medication errors, Nursing Staff, Not Reporting, Inpatient Wards, Teaching Hospital ¬Citation:Ebrahimipour H, Mahmoudian P, Hosseini SE, Badiee S, Tabatabaee SS, VafaeeNajar A, Haghighi H.Factors Associated with the Incidence of Medication Errors and Nurses' Refusal to Error Reporting. Journal of Health Based Research 2016; 1(3): 241-253

Apical Debris Extrusion with Conventional Rotary and Reciprocating Instruments

Introduction: The aim of the present study was to compare the amount of apical debris extrusion after preparation using hand files, reciprocating files, and full rotary nickel-titanium systems. Methods and Materials: One hundred extracted human mandibular molars with two separated canals in mesial root were divided into five groups and prepared using reciprocating systems (Reciproc and Safesider endodontic reamer files), full rotary systems (Mtwo and Neoniti A1 files) and hand instrumentation systems. Endodontic access was prepared and a #15 K-file was passed beyond the apex of the mesiobuccal canal by 1 mm to ensure the canal patency. All mesiobuccal canals were prepared 1 mm shorter than the anatomic apex. In each case, extruded debris was collected in an Eppendorf tube and weighed after desiccation. The mean weight of extruded material was calculated in each group. The analysis was carried out using the Kruskal–Wallis test followed by two tailed and Mann-Whitney U test at a significance level of 0.05. The Bonferroni correction was also applied to correct multiple comparisons. Results: There was a statistically significant difference between the reciprocal and other techniques in debris extrusion (P&lt;0.05). The order of groups ranked in terms of debris extrusion from the lowest to highest was as follows: 1) Hand instrumentation group (with crown down technique), 2) Mtwo group, 3) Neoniti A1 group, 4) Safesider endodontic reamer group, and 5) Reciproc group. Conclusion: Based on this in vitro study, all systems have some apical debris extrusion; however, using the hand instrumentation system resulted in extrusion of significantly less debris compared to the Reciproc group. It seems that hand and rotary instrumentation systems are better than reciprocating instrumentation systems in terms of the amount of debris extrusion.Keywords: Endodontics; Root Canal Preparation; Rotary Instrumentatio

A Synergetic Intelligent Fault Prognosis Framework to support Product Life Cycle Considering Environmentally Conscious Production

ABSTRACT: The recent problems of increased oil prices, global warming, and environmental pollution highlighted the urgent need for cost effective, reliable and environmentally conscious production process. Hence to achieve clean and healthy production, the chemical process industry strives to continually improve their preparedness and awareness through adaptive inference logic by effectively extracting and signaturing cascade clues from past experiences and predicting the possible scenarios of risk and its sources. These sources are usually related to equipment life cycle, starting from suppliers’ evaluation and ending by its salvage or disposal. Methods are thus needed to effectively utilize data collected and knowledge available in order to make the right decision at the right moment. Despite the considerable technological advancement, these decisions still depend heavily on human expertise, which is, although very valuable, are subject to errors, and may be lost due to death, retirement or resignation. Therefore, an integrated equipment health management system that takes into consideration the equipment life cycle, which leads to environmentally conscious production, is proposed. In order to manage and develop environmentally conscious plant operation, it is essential to provide a synergetic intelligent fault diagnosis and prognosis framework embedded in systematic interoperable platform with respect to product life cycle, process safety and environmental measures. The proposed system employs a systematic expert knowledge structure considering operation execution, process safety and control, warranty policies, and environmental issues during equipment life cycle to assist the user in evaluating uncertainties and the process of decision making

Isolation and Identification of Crude Oil Degrading and Biosurfactant Producing Bacteria from the Oil-Contaminated Soils of Gachsaran

Background and Objectives: Petroleum hydrocarbons are harmful to the environment, human health, and all other living creatures. Oil and its byproducts in contact with water block sunshine to phytoplanktons and thus break the food chain and damage the marine food source. This study aims to isolate the crude oil degrading and biosurfactant producing bacteria from the oil contaminated soils of Gachsaran, Iran. Materials and Methods: Isolation was performed in peptone-water medium with yeast extract. Oil displacement area, emulsification index and bacterial phylogeny using 16S rRNA analysis were studied. Results and Conclusion: Three isolates were able to degrade the crude oil. In the first day, there were two phases in the medium; after a few days, these three bacteria degraded the crude oil until there was only one phase left in the medium. One strain was selected as a superior strain by homogenizing until the medium became clear and transparent. This method confirmed that the strain produces biosurfactant. According to the morphological and biochemical tests, the strain isolated from the oil contaminated soils is a member of Bacillus subtilis, so to study the bacterial phylogeny and taxonomy of the strain, an analysis of 16S rRNA was carried out, and the phylogenic tree confirmed them. The results verified that oil contaminated soils are good source for isolation of the biosurfactant producing bacteria

Women’s needs in their journey toward motherhood via oocyte donation: A mixed methods systematic review

Background: Given the significant changes in family formation through donation procedures, providing an optimal level of care that is responsive to the needs of mothers who get pregnant via oocyte donation is pivotal to improve their maternal role. Therefore, it is necessary to recognize the needs of oocyte donation mothers to address their specific needs. Objective: This study aimed to review the needs of women in their journey toward motherhood via oocyte donation. Materials and Methods: In this systematic review, which followed the updated Joanna Briggs Institute’s methodological guidance for conducting a mixed methods systematic review, the quantitative observational and qualitative studies were searched through databases including PubMed, Web of Science, PsycINFO, the Cochran Library, and Google Scholar search engine. Letters to the editor, commentaries, magazine articles, articles without full text and abstracts presented in congresses were excluded. All English-language articles related to the needs of oocyte donation mothers, without time limitations, were reviewed. The eligible studies were critically appraised independently by 2 researchers. Results: 4649 records were identified from those 18 articles that were finally included in the review. The needs of oocyte donation mothers comprised 8 categories: The need for special services in fertility clinics, the need to improve the quality of care, the need for emotional support and psychological consultation, information needs, the need for financial support, the need for disclosure counseling, educational needs, and the need for sociocultural and religious support. Conclusion: This review suggests various needs of oocyte donation mothers. The results can be used in carefully planning supportive programs for this vulnerable population. Key words: Need, Women, Oocyte donation, Motherhood

Isolation and genetic characterization of metallo-β-lactamase and carbapenamase producing strains of Acinetobacter baumannii from patients at Tehran hospitals

International audienceBACKGROUND AND OBJECTIVE: Carbapenems are therapeutic choice against infections caused by gram-negative bacilli including strains of Acinetobacter baumannii. Resistance to these antibiotics is mediated by efflux pumps, porins, PBPs and ß-lactamases. The aim of this study was to determine the possibility of existence of MBLs, OXAs and GES-1 betalactamase genes among clinical isolates of Acinetobacter collected from Tehran hospitals. MATERIAL AND METHODS: Two hundred and three Acinetobacter isolates were collected from patient at Tehran hospitals. The isolates were identified using biochemical tests. The susceptibility to different antibiotics was evaluated by disk diffusion method and MICs of imipenem were determined using Micro broth dilution method (CLSI). PCR was performed for detection of bla(VIM-2), bla(SPM-1), bla(IMP-2), bla(GES-1), bla(OXA-51), bla(OXA-23) betalactamase genes. Clonal relatedness was estimated by PFGE with the restriction enzyme SmaI. RESULTS AND CONCLUSION: Of 100 isolates of imipenem resistant Acinetobacter spp. collected from Tehran hospitals in 2009 and 2010, 6 isolates produced metallo-beta-lactamases and 94 isolates produced OXA-type carbapenemase. The bla(SPM-1), bla(GES-1), bla(OXA-51), bla(OXA-23) genes were detected by PCR among 6, 2, 94 and 84 isolates of A. baumannii, respectively. The MICs of isolates to imipenem were 8-128 µg/mL. PFGE analysis of 29 bla(OXA-51) and bla(OXA-23)-positive A. baumannii isolates gave 6 different patterns. This is the first report of SPM-1 and GES-1 beta-lactamase producing A. baumannii. Production of the OXA-23, OXA-51, GES-1 and SPM-1 enzyme presents an emerging threat of carbapenem resistance among A. baumannii in Iran