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

The pattern of acute poisoning in hospitalized children under 18 years old of Yazd, Iran

Acute poisoning is a common cause of emergency department visits in childhood and can increase children’s morbidity and mortality. Since the causes of child poisoning in different parts of Iran may differ due to cultural differences, this study was conducted to evaluate the most common causes of poisoning in Yazd. This retrospective cross-sectional study is based on the medical records of children less than 18 years of age admitted to the pediatric emergency department at Shahid Sadoughi Hospital in Yazd during 2018. The collected data included demographic information, the cause, and the outcome of acute poisoning. Out of 105 cases, 61.9% were boys. The highest poisoning rates were in the age group of 1 to 4 years (55.2%). In 50% of the participants, the family size was five or more, and 91% had Iranian nationality. Drugs were identified as the most common causes of poisoning (51.4%), and opioid analgesics were the most frequent drugs. The most common complaint at the time of referral in patients was the loss of consciousness (33%). The mean hospital stay was 56 hours, and no death was reported. According to the findings of this study in Yazd, the probability of accidental poisoning in boys under four years and due to different types of drugs, especially opioids, was higher than others. It seems that increasing parents’ awareness about keeping drugs used by family members in a safe place and out of children’s reach is essential in preventing poisoning

The Comparison of The Efficacy of Photobiomodulation and Ultrasound in the Treatment of Chronic Non-specific Neck Pain: A Randomized Single-Blind Controlled Trial

Introduction: Chronic neck pain is a common complaint among office workers. The aim of the present study was to compare the efficacy of a high-intensity laser and physiotherapy in office workers who were diagnosed with chronic non-specific neck pain.Methods: This study was a single-blind randomized controlled trial, with parallel allocation. Sixty office workers with chronic neck pain, aged between 25 and 55 years, participated in the study. The participants were randomly divided into two groups: photobiomodulation (by a high-level laser) and physiotherapy. Visual analog scale (VAS), Neck Disability Index (NDI), Neck Pain and Disability Scale (NPDS), and Bournemouth Questionnaire (BQN) were completed on three occasions (before, immediately, and 2 weeks after the intervention) to assess and compare the efficacy of the high-intensity laser and physiotherapy in neck pain. Data were analyzed by SPSS 23 software using the chi-square test, Student’s t-test, multivariate tests, and Fisher’s exact test.Results: The mean age of the participants was 37.53±9.52 and 41.16±7.85 years in physiotherapy and laser therapy respectively. The VAS score and NDI scores decreased after both kinds of interventions, and the effect of photobiomodulation was significantly higher than physiotherapy (P<0.001). Both treatment modalities significantly affect different aspects of chronic neck pain assessed by NDPS and BQN questionnaires and the effect of photobiomodulation was more prominent than physiotherapy.Conclusion: The findings of this study showed that photobiomodulation and physiotherapy can reduce chronic neck pain and its different aspects and the effect of laser therapy was significantly higher than physiotherapy DOI: 10.34172/jlms.2021.2

Maternal and neonatal outcomes among pregnant women with different polycystic ovary syndrome phenotypes: A cross-sectional study

Background: Pregnancy is a process associated with various metabolic and hormonal changes, and polycystic ovary syndrome (PCOS) can affect this process. Objective: This study aimed to evaluate and compare the maternal and neonatal outcomes among pregnant women with different polycystic ovary syndrome phenotypes. Materials and Methods: In this cross-sectional study, 200 pregnant women with PCOS according to the 2003 ESHRE/ASRM criteria were categorized into four phenotype groups (A-D). The maternal outcomes include gestational diabetes mellitus, pregnancy-induced hypertension, premature rupture of membranes, preterm labor, small-for-gestational age birth, intrauterine growth restriction, intrauterine mortality, preeclampsia, abortion, amniotic fluid disorders, delivery method, and cause of cesarean section were studied between groups. Additionally, neonatal outcomes such as neonatal weight, neonatal recovery, 5-min Apgar score, neonatal icter, the need for NICU admission, the cause of hospitalization, and infant mortality rate were investigated and compared among the groups. Results: According to the results, phenotype D (37%) was the most common phenotype among the participants. The risk of gestational diabetes was more common in phenotype A than in the other phenotypes, whereas pregnancy-induced hypertension was most common in phenotype B. No significant differences were observed in the neonatal complications among the PCOS phenotypes. Conclusion: Considering the higher risk of gestational diabetes mellitus and pregnancy-induced hypertension in PCOS phenotypes A and B, women with these phenotypes need more precise prenatal care. Key words: Pregnancy outcome, Polycystic ovary syndrome, Phenotype, Pregnancy

Relationship between organizational intelligence and performance indicators of teaching hospitals: a case study in Iran

Background: One of the greatest managerial challenges is how to generate  intelligent organizations that can quickly adopt themselves according to environmental changes to guarantee their success and survival in a turbulent external environment.Objectives: Study objective was to assess the relationship between organizational intelligence and performance indicators of teaching hospitals affiliated by Shahid Sadoughi University of Medical Sciences (YUMS) in 2015.Design: This was a descriptive, cross-sectional study conducted in three teaching hospitals affiliated by YUMS in 2015. Data were collected using a standard questionnaire developed by Albrecht and analyzed by SPSS 16 using descriptive and correlation statistical tests.Setting of the study: Hospitals affiliated by Shahid Sadoughi University of Medical Sciences in Yazd, Iran.Subjects/ participants: A sample of 300 personnel working in under study hospitals who’ve been selected through stratified random sampling method.Results: Results confirmed that scores of organizational intelligence in understudy hospitals were in the optimum status. Conditions of three performance indicators including average length of stay, bed turnover and bed occupancy rate were analyzed to be appropriate. A significant statistical correlation between organizational intelligence and bed occupancy rate, total number of admitted and discharged patients and finally number of patients’ death was seen (p<0.05).Conclusion: Having an appropriate plan or decision strategies to strengthen organizational intelligence can play an effective role in hospital performance improvement

Prevalence of Mastalgia and the complications attributed to it following Mirena Intrauterine device Insertion: A prospective cohort study

Background: The unprecedented increase in population around the globe has led to considering family planning policies in recent decades. Intrauterine device (IUD) is one of the most effective methods of contraception; yet, this method is associated with complications and problems that cause its removal.Objectives: This study aims to evaluate mastalgia and the complications attributed to it following Mirena IUD in women referring to medical centers in Yazd.Methods: In this prospective cohort study, 201 women using Mirena IUD who referred to the Gynecology Ward of two public and private hospitals in Yazd province were followed up for 6 months from November 2021 to June 2022. Data were gleaned using a data questionnaire including age, parity, duration of IUD use, and IUD complications and analyzed with SPSS22 using descriptive and analytical statistical chi-square.Results: Of 201 women studied, 48 (36.9%) reported mild mastalgia, 7 (3.5%) had moderate mastalgia, and 12 (6%) reported severe mastalgia after IUD insertion. After 6 months, 54 (37.9%) participants had mild mastalgia, 10 (5%) reported moderate mastalgia, and 12 (6%) reported severe mastalgia. Moreover, among the complications of IUD, menstrual spotting was reported in the majority of participants (57.2%), followed by pelvic pain (28.9%), dyspareunia (27.9%), and nausea (17.4%) as the most common complications, respectively.Conclusion: According to this study, mastalgia in women using IUD is the most common complication, second to abnormal uterine bleeding, and is not related to the age and parity of the participants. Also, IUD breast complications are relatively common, and more studies are needed to investigate these complications

Road traffic accidents in Yazd province, Iran: A longitudinal study (2012-2016)

Background and Objectives: The victims of road traffic accidents (RTAs) are mainly young. Hence, reduction of mortality from RTAs should be considered as one of the most important priorities for health-care systems. This study aimed at assessing the mortality rate of RTAs in Yazd Province during 2012-2016. Subjects and Methods: In this descriptive-analytic study, data were obtained from data collection forms of forensic medicine organizations in Yazd. The general equation estimation method was used to compare the number of accidents by distinguishing independent variables. To investigate the trend, a decomposition method was used to analyze a time series with a trend and a seasonal pattern in the Minitab software. Results: In this study, 1437 people who died due to RTAs during 2012-2016 were studied. The number of deaths in men was 1076 (75), almost three times of women. The risk of death from RTAs in married couples, the main road, heavy car driving and driving out-of-town were 1.6, 3.6, 1.9, and 3.2, respectively. An indirect and significant linear relationship was found between the number of accidents and time during 2012-2016. Conclusion: According to the results of this study, the most cases of events are in the age group of 20-30 years. Therefore, prevention should be done for this age group. Furthermore, findings of this study show that decreasing in fatal RTA can be attributed to the exacerbation of traffic regulations and its implementation

Hearing Thresholds Changes after MRI 1.5T of Head and Neck

INTRODUCTION: Exposure to high intensity noise produced by MRI is a cause for concern. This study was conducted to determine the temporary and permanent effects of exposure to noise created by performing MRI on the hearing threshold of the subjects using conventional and extended high frequency audiometry. METHODS: This semiexperimental study was performed on 35 patients referred to Shahid Rahnemoun Hospital for head and neck MRI due to different clinical conditions. The hearing threshold of patients was measured before, immediately after, and 24 hours after performing 1.5 Tesla MRI using conventional and extended high frequency audiometry. SPSS version 18 was used to compare the mean hearing thresholds before and after MRI using paired T test and repeated measures analysis. RESULTS: Comparison of auditory thresholds in conventional and extended high frequencies before and immediately after MRI showed a significant shift at 4 KHz (P = 0.008 and P = 0.08 for right and left ears), 6 KHz (P = 0.03 and P = 0.01 for right and left ears), and 14 KHz (P =0.03 and P = 0.31 for right and left ears). However, there was no significant difference between audiometric thresholds before and 24 hours after MRI. CONCLUSION: Noise due to 1.5 Tesla MRI can only cause transient threshold shift

اولویت‌بندی و بررسی میزان رعایت ارزش‌های اخلاق حرفه‌ای از دیدگاه پرستاران بیمارستان‌های منتخب شهر یزد

زمینه و هدف: رعایت اصول اخلاقی در ارائه مراقبت به بیمار بر انجام مراقبت تقدم دارد و رعایت اخلاق حرفه‌ای یکی از اجزای ضروری حرفه پرستاری می‌باشد. با توجه به این مهم، مطالعه حاضر با هدف اولویت‌بندی و بررسی میزان رعایت ارزش‌های اخلاق حرفه‌ای از دیدگاه پرستاران بیمارستان‌های منتخب شهر یزد در سال 1400 انجام شده است. روش: مطالعه حاضر، مطالعه‌ای توصیفی ـ مقطعی بوده که در دو بیمارستان منتخب (الف و ب) شهر یزد در سال 1400 و در نمونه‌ای 100 نفری از پرستاران که به روش طبقه‌ای ـ تصادفی انتخاب شده‌اند، انجام شده است. داده‌‌ها با استفاده از پرسشنامه محقق‌ساخته که برگرفته از ابعاد ده‌گانه ارزش‌های اخلاقی پرستاری مصوب وزارت بهداشت در سال 1390 می‌باشد، جمع‌آوری شده است. نتایج با استفاده از آمار توصیفی (فراوانی، درصد، میانگین و انحراف معیار) و در نرم‌افزار SPSS 20 تجزیه و تحلیل شده است. ملاحظات اخلاقی: این مطالعه توسط کمیته اخلاق تأیید گردیده است. ملاحظات اخلاقی نظیر تکمیل فرم رضایت کتبی آگاهانه، مشارکت داوطلبانه، توضیح اهداف تحقیق و اطمینان در مورد محرمانه‌بودن اطلاعات رعایت گردید. یافته‌‌ها: از میان ابعاد ده‌گانه ارزش‌های اخلاقی پرستاری، پرستاران بیشترین اولویت را به ترتیب برای ابعاد پایبندی به تعهدات حرفه‌ای (03/2±140)، شفقت و مهربانی (4/3±120) و ارتقای آگاهی از مقررات حرفه‌ای (3/1±115) قائل بوده‌اند. همچنین 79 درصد از پرستاران، میزان رعایت ارزش‌های اخلاقی را در وضعیت خوب ارزیابی کرده‌اند. نتیجه‌گیری: با توجه به اولویت ابعاد ارزش‌های اخلاقی، توجه به تعهدات حرفه‌ای، شفقت و مهربانی و همچنین ارتقای آگاهی از مقررات حرفه‌ای در برنامه‌‌های آموزش مداوم پرستاری، می‌تواند در ارتقای کیفیت عملکرد بیمارستان و رضایت بیماران مؤثر باشد.Background and Aim: In patient care provision, observing ethical principles is prior to care delivery and observing professional ethics is among the essential components of the nursing profession. Considering this important fact, the present study was conducted with the aim of prioritizing and investigating the degree of observing professional ethics values from the perspective of the nurses in the selected hospitals in Yazd in 1400. Methods: The present study is a descriptive cross sectional study, which was conducted in 2021 in the two selected hospitals in Yazd (A, B). The samples consisted of 100 nurses, who were selected through stratified-random method. The data were collected using a researcher-made questionnaire, deriving from the 10-dimension Nursing ethical values approved by the Ministry of Health in 2011. The results were analyzed in SPSS 20 software using descriptive statistics (frequency, percentage, mean, and standard deviation). Ethical Considerations: The present study has been approved by the ethics committee. Ethical considerations have been observed, including completing the written informed consent form, voluntary participation, explaining the research objectives and ensuring data confidentiality. Results: Among the 10 dimensions of nursing ethical values, the nurses prioritized professional adherence (140±2.03), compassion and kindness (120±3.4) and promoting the awareness of professional regulations (115±1.3), respectively. In addition, 79% of the nurses assessed the degree of observing ethical values as good. Conclusion: Considering the priority of ethical values, paying attention to professional adherence, compassion and kindness, and promoting the awareness of professional regulations in continuous nursing education programs can be effective in improving the quality of hospital performance and the degree of patient satisfaction. Please cite this article as: Askari R, Dehghani Ashkazari F, Shamsi F. Prioritizing and Investigating the Degree of Observing Professional Ethics Values from the Perspective of the Nurses in the Selected Hospitals. Faṣlnāmah-i akhlāq-i pizishkī, i.e., Quarterly Journal of Medical Ethics. 2022; 16(47): e23.زمینه و هدف: رعایت اصول اخلاقی در ارائه مراقبت به بیمار بر انجام مراقبت تقدم دارد و رعایت اخلاق حرفه‌ای یکی از اجزای ضروری حرفه پرستاری می‌باشد. با توجه به این مهم، مطالعه حاضر با هدف اولویت‌بندی و بررسی میزان رعایت ارزش‌های اخلاق حرفه‌ای از دیدگاه پرستاران بیمارستان‌های منتخب شهر یزد در سال 1400 انجام شده است. روش: مطالعه حاضر، مطالعه‌ای توصیفی ـ مقطعی بوده که در دو بیمارستان منتخب (الف و ب) شهر یزد در سال 1400 و در نمونه‌ای 100 نفری از پرستاران که به روش طبقه‌ای ـ تصادفی انتخاب شده‌اند، انجام شده است. داده‌‌ها با استفاده از پرسشنامه محقق‌ساخته که برگرفته از ابعاد ده‌گانه ارزش‌های اخلاقی پرستاری مصوب وزارت بهداشت در سال 1390 می‌باشد، جمع‌آوری شده است. نتایج با استفاده از آمار توصیفی (فراوانی، درصد، میانگین و انحراف معیار) و در نرم‌افزار SPSS 20 تجزیه و تحلیل شده است. ملاحظات اخلاقی: این مطالعه توسط کمیته اخلاق تأیید گردیده است. ملاحظات اخلاقی نظیر تکمیل فرم رضایت کتبی آگاهانه، مشارکت داوطلبانه، توضیح اهداف تحقیق و اطمینان در مورد محرمانه‌بودن اطلاعات رعایت گردید. یافته‌‌ها: از میان ابعاد ده‌گانه ارزش‌های اخلاقی پرستاری، پرستاران بیشترین اولویت را به ترتیب برای ابعاد پایبندی به تعهدات حرفه‌ای (03/2±140)، شفقت و مهربانی (4/3±120) و ارتقای آگاهی از مقررات حرفه‌ای (3/1±115) قائل بوده‌اند. همچنین 79 درصد از پرستاران، میزان رعایت ارزش‌های اخلاقی را در وضعیت خوب ارزیابی کرده‌اند. نتیجه‌گیری: با توجه به اولویت ابعاد ارزش‌های اخلاقی، توجه به تعهدات حرفه‌ای، شفقت و مهربانی و همچنین ارتقای آگاهی از مقررات حرفه‌ای در برنامه‌‌های آموزش مداوم پرستاری، می‌تواند در ارتقای کیفیت عملکرد بیمارستان و رضایت بیماران مؤثر باشد

Prevalence of Obesity and its Relationship with Birth Weight among High School Female Students in the City of Yazd

Introduction: The idea that factors during early critical periods of life affect on long term health is now a major public health concern. In this study, in addition to investigating obesity prevalence among female high school students in Yazd, the relationship between obesity and birth weight was examined. Materials and Methods: This cross sectional study was conducted on 312 female high school students. Random cluster sampling method was done among 6 high schools from two education districts in Yazd. According to the birth weight recorded on their growth cards, the students were divided to 3 weight groups of low birth weight (4000 g). Anthropometric measurements including weight, height and waist circumference were alsocarried out. In terms of the percentiles proposed by NCHS, BMI was considered as light weight (5th percentile≤), normal (5-85th percentile), overweight (85-95th percentile) and obese (95th percentile≥). In addition, 95th percentile≥for waist circumference was considered abdominal obesity. Finally, the data were analyzed by SPSS 16 software. Results: The samples' mean weight and BMI were higher than 50th percentile of NCHS and their mean height was lower than 50th percentile of NCHS. Based on the results, 5.7% of the samples were underweight, 73.4% were normal, 17.1% were overweight and 3.8% were obese. Abdominal obesity rate was measured as 18.7%. There was a significantly positive correlation between birth and current weight of students (p= 0.001 and r= 0.2) and their BMI (p= 0.005 and r= 0.15). Conclusion: Relatively high prevalence of obesity and overweight in this study and its positive relationship with birth weight necessitate preventive strategies and training during and even before pregnancy by relevant authorities for women at gestational age and other related groups