Comparing the Diagnostic Value of Hysterosalpingography with Hysteroscopy in Diagnosis of Uterine abnormalities in Infertile Women

Background & aim: Despite the identification of hysteroscopy as the most accurate method for the diagnosis of uterine cavity disorders, the patients are initially subjected to hysterosalpingography (HSG).  In this regard, the present study aimed to compare the diagnostic value of HSG and hysteroscopy in the detection of uterine cavity abnormalities in infertile women. Methods: This cross-sectional study was conducted on 91 infertile women who needed to undergo hysteroscopy in the Gynecology Ward of Imam Reza Hospital in Mashhad, Iran, due to the detection of a uterine abnormality in their HSG or failure of intrauterine insemination and in vitro fertilization during 2013 to 2014. The results of HSG and hysteroscopy to detect uterine cavity changes were compared. Data analysis was performed in SPSS software (version 16) using McNemar’s test. P-value less than 0.05 was considered statistically significant. Results: Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of HSG were 38.78%, 78.57%, 67.86%, 52.38%, and 57.14%, respectively, in comparison to those of hysteroscopy. The results of the McNemar’s test revealed a significant difference between the results of HSG and hysteroscopy in the diagnosis of uterine cavity abnormalities (P=0.001). Conclusion: As the findings indicated, HSG had lower sensitivity, specificity, as well as positive and negative predictive values. Consequently, this method can be concluded as insufficient for the diagnosis of endometrial cavity disorders and incapable of diagnosing many factors affecting the outcome of infertility treatments. Therefore, all infertile women who are candidate for laparoscopy or those who need expensive infertility treatments are suggested to undergo hysteroscopy before the onset of treatment

The effect of spiritual vitality training program on athletes\' fear of failure and psychological security

Background: The literature in sports psychology showed that a decrease in the feeling of psychological security probably caused a decrease in success and thus caused fear and anxiety. As a result, sports psychologists have focused on training programs to overcome the reduction in feelings of psychological security and fear. Aims: The purpose of this study was to evaluate the effect of spiritual vitality training program and evaluation on fear of failure and psychological security of athletes. Methods: In this quasi-experimental study with a pre-test-post-test research design, 46 female athletes were selected by voluntary participation, and randomly divided into two groups of spiritual vitality and control training programs. Participants completed pre-test and post-test questionnaires of psychological security (Edmondson, 1999) and fear of failure (Conory et al, 2002). The intervention phase was performed in 28 one-hour sessions. This protocol was a combination of the protocol of spiritual vitality (eight sessions), consciousness in the moment (ten sessions) and acceptance and awareness (ten sessions) (Mehry Varnayeb, 2017). During this time, the participants in the control group engaged in their daily activities. Data were analyzed by multivariate and univariate analysis of covariance. Results: The results of multivariate analysis of covariance showed that spiritual vitality training program has a significant effect on reducing the fear of failure (ie, decreased self-esteem, fear of having an unknown future, fear of upsetting important people, fear of experiencing shame and fear of losing Giving interest to important people (athletes) (P<0.05). It also showed that spiritual vitality training program has a significant effect on increasing the sense of psychological security of athletes (P<0.05). Conclusion: The results showed that spiritual vitality program has been effective in reducing the fear of failure and increasing the feeling of psychological security of the athletes through self-control and it is important for experts to be aware of this program in order to reduce the fear of failure and improve the safety of athletes

Autosomal Recessive Bestrophinopathy: Clinical and Genetic Characteristics of Twenty-Four Cases

Background. To describe ocular manifestations, imaging characteristics, and genetic test results of autosomal recessive bestrophinopathy (ARB). The study design is an observational case series. Methods. Forty-eight eyes of 24 patients diagnosed with ARB underwent complete ophthalmic examinations including refraction, anterior and posterior segment examination, enhanced depth imaging optical coherence tomography (EDI-OCT), fluorescein angiography (FA), electroretinography (ERG), and electrooculography (EOG). Optical coherence tomography angiography (OCTA) and BEST1 gene sequencing were performed in selected patients. Results. The age at onset was 4–35 years (mean: 18.6 years). The male-to-female ratio was 0.45. All patients were hyperopic, except one with less than one diopter myopia. EOG was abnormal in 18 cases with near-normal ERGs. Six patients did not undergo EOG due to their young age. Eighteen patients (75%) had a thick choroid on EDI-OCT, of which three had advanced angle-closure glaucoma, 15 patients were hyperopic, and eight of them had more than four diopters hyperopia in both eyes. Macular retinoschisis was observed in 46 eyes of 23 patients (95%) with cysts mostly located in the inner nuclear layer (INL) to the outer nuclear layer (ONL). Of the 18 patients who underwent FA, mild peripheral leakage was seen in eight eyes of four patients (22%). Subfoveal choroidal neovascularization (CNV) was seen in three eyes of two patients (6%) that responded well to intravitreal bevacizumab (IVB). Seven mutations of the bestrophin-1 (BEST1) gene were found in this study; however, only two of them (p.Gly34 = and p.Leu319Pro) had been previously reported as the cause of ARB based on ClinVar and other literature studies. Conclusions. ARB can be presented with a wide spectrum of ocular abnormalities that may not be easily diagnosed. Pachychoroid can occur alongside retinal schisis and may be the underlying cause of angle-closure glaucoma in ARB. Our study also expands the pathogenic mutation spectrum of the BEST1 gene associated with ARB