Birth prevalence of genital anomalies among males conceived by intracytoplasmic sperm injection cycles: A cross-sectional study

Background: Several studies have been conducted worldwide to evaluate the prevalence and relative risks of congenital anomalies associated with assisted reproductive technology cycles; however, there is limited data in Iran. Objective: To investigate male genital anomalies among live births from assisted reproductive technology. Materials and Methods: This cross-sectional study was conducted on children born after intracytoplasmic sperm injection (ICSI) at Royan Institute, Tehran, Iran from April 2013-December 2015. The prevalence of male genitalia disorders that included hypospadias, epispadias, cryptorchidism, micropenis, and vanishing testis were reported. The relationship between the cause of infertility and type of embryo transfer (fresh or frozen), gestational age at birth (term or preterm), and birth weight with these male genitalia anomalies were evaluated. Results: In total, 4409 pregnant women were followed after their ICSI cycles to evaluate genitalia anomalies in their children. Out of 5608 live births, 2614 (46.61%) newborns were male, of which 14 cases (0.54%) had genital anomalies. The prevalence of various anomalies were cryptorchidism (0.34%), hypospadias (0.038%), micropenis (0.038%), vanishing testis (0.038%), and epispadias (0.077%). No relationship was found between the cause of infertility, type of embryo transfer (fresh or frozen), gestational age at birth (term or preterm), and male genital malformation (p = 0.33, p = 0.66, and p = 0.62, respectively). Conclusion: The prevalence of each male genital anomaly after the ICSI cycle was rare and less than 0.5%; however, no significant infertility-related factor was observed with these anomalies. Key words: Cryptorchidism, Hypospadias, Microinjections, Prevalence, Reproductive techniques, Urogenital abnormalitie

Students’ Educational Problems, Presented in the University’s Educational Councils from 2002 to 2005, Shahrekord University of Medical Sciences

Background & Objective : An educational council, one of the most important parts of each university, plays the main role in solving students’ educational problems. This study was aimed to analyze the students’ educational problems in Shahrekord University of Medical Sciences, according to the councils’ minutes from 2002 to 2005. Methods : In this study, 333 cases of the students’ educational problems were extracted from the minutes of 66 educational councils’ meetings during a period of four years. They were analyzed according to the students’ study field, level, turn (morning or evening courses), sex, and the state of being native. Results : Among all, request for omitting a course, educational leave, and registering a course were the most frequent problems. Non native students’ educational problems were more than native ones (6.8% and 4.3% respectively) and males’ problems (9.8%) were more than females’ (3.8%) (p=0.0001). Educational problems among students of medicine (8.4%), radiology (7.6%), and field of fighting against diseases (5.9%) were more frequent than others. The difference between the frequency of problems in the students attending morning classes (5.3%) and those attending evening classes (5.2%) was not significant. Conclusion : This study revealed that the students’ educational problems were different in various study fields. There were significantly more problems in male and non native students (who are less supported by the families) compared to female and native ones. Family, financial and health problems, lack of enough knowledge among students and tutors about educational rules stood amongst the most important factors leading to the students’ educational problems. Keywords: Student’s educational problem, Educational council, University of Medical Sciences

Umbilical cord serum procalcitonin, as an early diagnostic marker of early neonatal sepsis

Background and Objective: The prognosis of early neonatal sepsis is significantly associated with rapid diagnosis and appropriate antibiotic therapy. Since blood culture has been reported positive in less than 16 of neonatal sepsis cases, various biochemical markers have been evaluated. This study was performed to evaluate the umbilical cord blood procalcitonin (PCT) as an early diagnostic marker of early neonatal sepsis. Methods: This cross-sectional study included 100 neonates in two groups of case and control. The case group consisted of three separate groups, including proven, suspected and clinical sepsis groups. The PCT level of umbilical cord blood was measured by immunoluminoassay method, and PCT 0.5-2ng/ml, 2-10 ng/ml and >10ng/ml were considered weakly positive, positive and strongly positive, respectively. Sepsis screening tests and a culture taken from blood or other sterile fluids were studied in the case group. Findings: The PCT mean was 1.39±1.52 and 0.17±0.05ng/ml in the case (sepsis) and control groups, respectively. Finally, the PCT level was significantly higher in all cases in the proven sepsis group than in other sepsis groups. Conclusion: The result of this study showed that the mean value of PCT level in umbilical cord blood was higher in the sepsis group, and it was higher in the proven sepsis group than in the other two groups of sepsis

The Effect of mode of delivery on the umbilical artery pH

Background: Abnormal umbilical cord pH can be indicated a distress imposed of newborn and can also be useful in determining the prognosis of the newborn. There are different views about the effect of the neonatal delivery method on the blood gas analysis of the umbilical artery. This study aimed to determine the effect of the method of delivery on umbilical artery pH. Methods: In this Cross-Sectional study, 150 singleton newborns of 37 to 42 weeks, with birth weight 2500 to 4000 g, were allocated. The samples were calculated for values, based on similar studies, and were divided into two groups, including vaginal delivery and caesarian section under spinal anesthesia which have the least difference in pH. Umbilical artery blood gas analysis of both groups were studied. Finally, using statistical T-test for the quantitative data and chi-square for the qualitative data, hypotheses were answered. P-value less than 0.05 was considered statistically significant. Results: Average gestational age was between 39±0.9 weeks and 76 (50.6%) and 74 (49.4%) of neonates were male and female respectively. The average birth weight was 3368.7±473.5 g. In this study, average umbilical artery pH at birth by vaginal delivery and by cesarean section was 7.25±0.06, 7.26 ±0.06 respectively (P>0.05). In this study, in both groups significant differences were seen in all the blood gas values except the umbilical cord artery pH. Conclusions: Our study showed that the pH level of umbilical artery blood was in normal range among newborns of both groups, but Po2 and Pco2 were more appropriate in vaginal deliveries. Due to the prognostic value of umbilical artery PH and the essentiality of prognosis in the newborns under stress, we recommend that this study should be done in the emergency situation, too

Relationship between Job Stress, Job Satisfaction, and Related Factors among Health Center Employees

Background and Objective: Job satisfaction and occupational stress are two factors affecting employees’ productivity at the workplace in developed organizations. Occupational stress causes various prevalent physical and psychological effects, which in turn leads to poor job satisfaction. Despite many studies in this field on health groups, less attention has been paid to health workers. Further research is thus needed to explore and explain how job stress and job satisfaction are related to personal work and organizational factors among health center workers. Materials and Methods: This analytic cross-sectional study was performed from winter 2018 to spring 2019 among health workers of a city in Markazi province, Iran. Data collection tools were demographic and individual characteristics questionnaire, Job Description Index (JDI) questionnaire, and Occupational Stress Questionnaire (OSQ, Davies). Data were analyzed using the SPSS software (version 20). Results: The results showed that occupational stress is generally higher in women (119/848) than in men (108/122), and women’s job satisfaction (242/450) is lower than that of men (262/682). In addition, there was a negative and significant relationship between occupational stress and job satisfaction (r=0.001, P=0.783) at the significance of level P<0.05. Multivariate regression findings also revealed that occupational stress can predict job satisfaction (β=-0.783, P=0.001). Moreover, the highest occupational stress and the lowest job satisfaction were related to healthcare workers. Conclusion: In general, stress and job satisfaction were obtained at a moderate level in this study, and there was a negative relationship between the two variables. Given that dissatisfaction is mainly seen in the discussion of promotions, salaries, and benefits, it is necessary to take measures to reduce stress, improve economic conditions, and create fair promotion conditions

T-helper Type 1 and 2 Cytokine Levels in Patients with Benign and Malignant Salivary Gland Tumors

ABSTRACT Background: Salivary gland tumors are among malignancies that have high recurrence rate. Immune responses in salivary gland tumors have not been well elucidated. T helper type 1 (Th1) and Th2 cytokines have been reported to play a role in the outcome of head and neck cancers. Objective: To evaluate the serum levels of interferon gamma (IFN-γ), as the hallmark of Th1 cytokines, and interleukin-4 (IL-4), as the hallmark of Th2 cytokines, in patients with benign and malignant salivary gland tumors in comparison with healthy controls. Methods: Fifty patients with benign and 14 patients with malignant salivary gland tumors, as well as 23 healthy individuals were recruited. Serum levels of IFN-γ and IL-4 were measured using ELISA method. Nonparametric tests were used for data analysis. Results: Serum levels of IFN-γ and IL-4 were found not to be significantly different in patients compared to the control group (0.68 ± 0.29 vs. 1.03 ± 0.57 pg/ml, p=0.58 for IFN-γ, 4.57 ± 1.57 vs. 4.41 ± 1.31 pg/ml, p=0.28 for IL-4). IFN-γ and IL-4 serum levels were also not significantly different between patients with benign and malignant salivary gland tumors (p=0.54 and p=0.86, respectively). Conclusion: The systemic levels of IL-4 and IFN-γ seem not to be associated with salivary gland tumor in our study. Investigation of other cytokines produced by Th1 and Th2 cells are warranted

Colonization of rectovaginal Escherichia coli and group B streptococci in mothers and on infants' body surface and their related risk factors

Background: Microorganisms that cause early neonatal sepsis are usually already colonized rectovaginal area in mothers. The most common of these organisms is group B streptococci (GBS) and intestinal gram-negative bacteria mostly Escherichia coli (E.coli). The use of prophylactic antibiotics against GBS has increased in recent years. This study aimed to determine the current situation and frequency of E.coli and GBS colonization in mothers and their infant. Methods: All pregnant women with gestational age≥26 weeks, progressive labor pain and no history of using antibiotic were entered into the current study. A sterile cotton swab culturing from distal third of vaginal and rectum of mothers, and six hours after delivery from external ear canal, nose, groin and umbilicus of infant has been taken. All samples were transferred to the laboratory in Stuart’s media, and then cultured to standard media within 24 hours and the main two organisms in neonatal sepsis (E.coli and GBS) were isolated from mothers' and infants' cultures. Results: E.coli and GBS were 56.3% and 11.2% respectively in rectovaginal culture, and 29.8% and 8.8% in infants’ body surface culture. There was a significant difference in rectovaginal GBS colonization between term (13.6%) and preterm (3.2%) (P=0.005), while the frequency of positive E.coli culture was 52.8% in term deliveries and 68.1% in preterm ones, showing a significant difference (P=0.009). Conclusions: Since E.coli is more common in preterm delivery in this geographical region, in cases of amniotic membrane rupture, mothers should be adequately protected with prophylactic antibiotics against neonatal sepsis

Insight into blood pressure targets for universal coverage of hypertension services in Iran: the 2017 ACC/AHA versus JNC 8 hypertension guidelines

BACKGROUND: We compared the prevalence, awareness, treatment, and control of hypertension in Iran based on two hypertension guidelines; the 2017 ACC/AHA -with an aggressive blood pressure target of 130/80 mmHg- and the commonly used JNC8 guideline cut-off of 140/90 mmHg. We shed light on the implications of the 2017 ACC/AHA for population subgroups and high-risk individuals who were eligible for non-pharmacologic and pharmacologic therapies. METHODS: Data was obtained from the Iran national STEPS 2016 study. Participants included 27,738 adults aged ≥25 years as a representative sample of Iranians. Regression models of survey design were used to examine the determinants of prevalence, awareness, treatment, and control of hypertension. RESULTS: The prevalence of hypertension based on JNC8 was 29.9% (95% CI: 29.2-30.6), which soared to 53.7% (52.9-54.4) based on the 2017 ACC/AHA. The percentage of awareness, treatment, and control were 59.2% (58.0-60.3), 80.2% (78.9-81.4), and 39.1% (37.4-40.7) based on JNC8, which dropped to 37.1% (36.2-38.0), 71.3% (69.9-72.7), and 19.6% (18.3-21.0), respectively, by applying the 2017 ACC/AHA. Based on the new guideline, adults aged 25-34 years had the largest increase in prevalence (from 7.3 to 30.7%). They also had the lowest awareness and treatment rate, contrary to the highest control rate (36.5%) between age groups. Compared with JNC8, based on the 2017 ACC/AHA, 24, 15, 17, and 11% more individuals with dyslipidaemia, high triglycerides, diabetes, and cardiovascular disease events, respectively, fell into the hypertensive category. Yet, based on the 2017 ACC/AHA, 68.2% of individuals falling into the hypertensive category were eligible for receiving pharmacologic therapy (versus 95.7% in JNC8). LDL cholesterol< 130 mg/dL, sufficient physical activity (Metabolic Equivalents≥600/week), and Body Mass Index were found to change blood pressure by - 3.56(- 4.38, - 2.74), - 2.04(- 2.58, - 1.50), and 0.48(0.42, 0.53) mmHg, respectively. CONCLUSIONS: Switching from JNC8 to 2017 ACC/AHA sharply increased the prevalence and drastically decreased the awareness, treatment, and control in Iran. Based on the 2017 ACC/AHA, more young adults and those with chronic comorbidities fell into the hypertensive category; these individuals might benefit from earlier interventions such as lifestyle modifications. The low control rate among individuals receiving treatment warrants a critical review of hypertension services

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries(1,2). However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world(3) and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health(4,5). However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular riskchanged from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.Peer reviewe