The Factors Predicting Quality of Life in Elderly People in Kerman Using PRECEDE Model

Background: As life expectancy and the population of old people increases, quality of life in elderly people becomes more important. The aim of this study was to determine the factors predicting quality of life in elderly people using PRECEDE model. Methods: This is a cross-sectional descriptive-analytical study. Data were collected using the World Health Organization Quality of Life (WHOQOL)–BREF questionnaire and another questionnaire including 67 questions according to the PRECEDE model components, which its reliability and validity were approved. Multi-stage random sampling method was used in two healthcare centers in Kerman and 80 elderly people were selected. Date were analyzed using linear regression and statistical indices via SPSS 15. Results: The mean age of participants was 67.7±7.1 years old, and most of them were female and married. The quality of life of elderly people was moderate. Among components of the PRECEDE model, knowledge (a component of predisposing factors) and enabling factors were the most significant factors predicting quality of life among the participants (R2 =0.46). Conclusion: According to the results, enabling factors and knowledge (a component of predisposing factors) were identified as the most important factors predicting quality of life. Therefore, more focus on these factors in educational programs for elderly people is recommended

When Is Non-Invasive Prenatal Testing Reliable in Pregnancies with a Vanishing Twin? - A Systematic Review of Case Reports

Background: Fetal demise can complicate aneuploidy screening in a multi fetal pregnancy. The cell-free DNA (CF-DNA) from a non-viable conception may be discordant with the viable fetuses. The Aim of study was to review the waiting period, follow-on single fetal demise in a twin gestation before performing NIPT (Non-Invasive Prenatal Testing).Methods: In this review article we searched through online databases of CINAHL, Cochrane, Database of Abstracts of Reviews of Effects (DARE), PubMed, Medical Library, and Google Scholar for English literature between 2011 to 2020, with the following keywords: “NIPT”, “non-invasive prenatal screening testing”, “cell-free DNA”, “vanishing twin” and “co-twin demise”. We included the studies regarding the duration between the twin vanishing or reduction and NIPT false results.Results: 201 studies across the eight scientific websites were detected; 178 of which were excluded for duplication or being irrelevant. And 29 studies were fully read. 4 case series, finally, met the criteria for systematic review. The findings suggested that the NIPT screening test can be falsely-positive several weeks after vanishing twins although the live fetus is normal. Therefore, the time duration in which the placenta can release CF-DNA of the vanished twin is unknown. In addition, several weeks after reduction, the fetal CF-DNA increases and then decreases, thus CF-DNA analyzing in multifetal pregnancies with reduction can be challenging as well.Conclusion: In pregnancies with vanishing twin or reduction, evaluating NIPT results is more complex than single fetal pregnancy. According to the reviewed studies, after a fetal demise, the cytotrophoblast continues to release to the CF-DNA in the maternal circulation for a variable time, which may cause a false-positive result if the demised twin is aneuploidy

Changes in SpirometricIndices among welders of a water heater making factory in Neyshabur, Iran after Four Years

Background: Welding is one of the most common industries in the world and welders are estimated to make up more than 1% of the work force in industrialized countries. The aim of this research was to study the respiratory index changes in these workers after four years working in this industry. Methods: This study included all welders working in one of the water heater making factories in Neyshabur who were 63 persons. Demographic information and respiratory complaints were collected by a questionnaire. Each worker's recent spirometry results were compared with his results from four years before using Paired-samples t­-test. Data analysis was performed using SPSS16 software. Results: The mean respiratory indices had all decreased after 4 years. The mean of FEV1 had decreased 0.12 L, ranging from 0.04 to 0.19, FVC had decreased 0.12 L, ranging from 0.03 to 0.2 and FEVI/FVC had decrease 77%, ranging from 0.11 to 1.31. This decrease was significant in all non-smoking welders, but not significant in smoking welders. Mucopurulent cough was the most common respiratory complaint among the welders. Conclusion: The findings may imply that welding is a high risk job that can negatively affect respiratory indices.Therefore it seems necessary to pay attention to preventive measures such as proper ventilation, using proper respiratory masks and environment health in this industry. Keywords: Welders, Spirometry test, Respiratory symptom

Evaluating risk factors of work-related musculoskeletal disorders in assembly workers of Nishabur, Iran using rapid upper limb assessment

Background: Work-related musculoskeletal disorders are one of the most common types of occupational injuries. They are also a major cause of workers’ disability. The aim of this study was to determine the prevalence of musculoskeletal disorders among the assembly workers of an electronic factory in Nishabur, Iran. Methods: This descriptive, analytical, cross-sectional study was conducted on 61 workers. The Standardized Nordic Questionnaire was used to estimate the prevalence of musculoskeletal disorders. Working postures were also recorded by photography and observation and evaluated by the rapid upper limb assessment (RULA). The collected data was analyzed by SPSS18. Results: The prevalence of musculoskeletal disorders in the wrist (33.0%), neck (21.3%), and waist (21.3%) was more than other parts of the body. The results of posture assessment in 32 groups of workers in the assembly saloon showed that 3.3% and 96.7% of the working postures needed first and second priority corrections, respectively. Weight and work history were significantly related with most disorders. Conclusion: Considering the high prevalence of musculoskeletal disorders in workers with short work experience, appropriate education and management are required to prevent the increased prevalence of these disorders in the future. Keywords: Rapid upper limb assessment, Posture evaluation, Musculoskeletal disorders, Workers, Assembl

Evaluation of Hearing Loss and Changes in Blood Pressure of Welders in a 4 Year Period

Improvements in science and technology and the use of modern machinery in manufacture have led to increase in the number of workers exposed to hazardous agents including noise. This study evaluated the effects of occupational noise on hearing loss and blood pressure in welders after 4 years.In this cohort study, all of the welders working at one of Neyshabur's water heater producing factories were studied. A questionnaire including demographic data, history of diseases and certain drug use was completed for each worker. Moreover the workers audiometry results and blood pressure measurements from 4 years ago were compared with recent results. Data analysis was performed using SPSS18software.The average age of the welders was of 35.6 ± 6.25 and the mean years of employment was 7.66 ± 2.18 years. The equivalent noise exposure of workers on one business day was 97.8 dB and varied between 90-110 dB. After 4 years, there was a significant increase in hearing loss (6.04 dB) in the right ear of workers at 8000 Hz (p=0.0001) and in the left ear at 1000 (1.77 dB)(p=0.04), 4000 (2.29 dB)(p=0.02)and 8000 Hz (4.89 dB)(p=0.0001). During this time blood pressure also increased but was not significant. There was no significant relation between age, years of employment, smoking and education with individual hearing loss during these four years. Many neglected job groups such as welders are prone to hearing loss and possibly chronic increases in blood pressure due to noise exposure in their workplace and should use protective hearing equipment

Awareness and apgar score in elective Cesarean section under general anesthesia with propofol or Isoflurane: A prospective, randomized, double-blinded clinical trial study

Background: Awareness is a postoperative recall of events experienced under general anesthesia. In this study, we compared the incidence of awareness between two routine methods used, inhalation (Isoflurane) and intravenous protocol (Propofol), in elective Cesarean section, and also evaluated the effect of these two different methods on the apgar score of newborns. Materials and Methods: In this prospective, clinical trial study, 90 pregnant women candidates for elective Cesarean section were randomly enrolled, after taking written consent. Induction of anesthesia in both groups was provided by propofol and succinylcholine in the same manner, and maintenance of anesthesia in Group 1 was provided by propofol 100 μg/kg/minute and in Group 2 with isoflurane 1 MAC, to maintain the bispectral index (BIS) between 45 and 60. Blood pressure, heart rate, electrocardiography (ECG), and also Etco2 and o2sat were recorded throughout the surgery and finally analyzed and compared. Results: From 90 patients, four cases of confirmed awareness were found in the propofol group and three cases in the Isoflurane group (8/9% vs. 6/7%), but the apgar scores were comparable between the two groups. Meanwhile there were no significant differences between the two groups in basic information, neonatal apgar scores, hemodynamic changes, and BIS, Electromyography (EMG), and signal quality index (SQI) values. Conclusion: According to the patient′s state, diagnosis of the anesthesiologist, and other criteria like price and its availability, we could use these drugs in general anesthesia during Cesarean section, although it is recommended that more studies be done to compare the effect of these two drugs in larger groups

Evaluation of the relation between cerebroplacental ratio, umbilical-cerebral ratio, and cerebro-placental-uterine ratio with the occurrence of adverse perinatal outcomes in pregnancies complicated by fetal growth restriction

Introduction: Fetal growth restriction (FGR) is a major obstetric complication associated with an increased risk of adverse perinatal outcomes. Objectives: This study aimed to evaluate the relationship between Doppler parameters, including the cerebroplacental ratio (CPR), umbilicocerebral ratio (UCR), and cerebro-placental-uterine ratio (CPUR), with adverse perinatal outcomes in singleton pregnancies complicated by FGR. Patients and Methods: This was a prospective study of 100 women with a singleton pregnancy 28 and 36.8 weeks of gestation was complicated by FGR and mild abnormalities. Feto-maternal Doppler examinations were conducted by the CPR, UCR, and CPUR parameters. Adverse outcomes were defined as Apgar score <7 at 5 minutes, preterm birth <37-week, neonatal intensive care unit (NICU) admission, fetal distress, and emergency cesarean section.These outcome parameters were checked with the results of the last ultrasound which performed 1-2 weeks before delivery. Results: Mean umbilical artery pulsatility index (UA-PI) (1.18±0.31 versus 1.04±0.21, P=0.010) and mean uterine arteries (UtAs)-PI (1.18±0.45 versus 0.96±0.36, P=0.20) were significantly higher in pregnancies that experienced adverse perinatal outcomes than those that did not experience them. Mean CPUR (1.82±1.03 versus 2.25±0.83, P=0.039) was significantly lower in pregnancies that experienced adverse perinatal outcomes versus those that did not. In binary multivariate logistic regression analysis, CPR, UCR, and CPUR parameters were evaluated with adverse perinatal outcomes. Only CPUR had a significant relationship with adverse perinatal outcomes. CPUR had a substantial relationship with Apgar score [removed

Evaluation of the relationship between pregnancy-associated plasma protein A (PAPP-A) and pregnancy outcomes

Background: In the current study, we aimed to evaluate the association between pregnancy-related plasma protein-A (PAPP-A) levels measured in the first trimester and pregnancy outcomes. Materials and Methods: This is a descriptive-analytical study that was performed in 2019--2021 on 1061 pregnant women in their first trimester. Demographic and basic information of all women were collected. These data included age, weight, parity, and date of delivery. Then the quantity of PAPP-A was recorded in three groups including less than 0.5 MOM, 0.5 to 2.5 MOM, and more than 2.5 MOM. Results: Data of 1061 women were analyzed. 900 women (84.8%) had term delivery and 155 women (14.6%) had pre-term deliveries. PAPP-A levels were normal in 83.4% of women. BMI and number of pregnancies had significant relationships with PAPP-A (p < 0.001, P = 0.03 respectively). The mean BMI in mothers with PAPP-A higher than 2.5 was significantly more than mothers with normal or lower PAPP-A levels (26.2 ± 31, P = 0.04). The frequency of term labor in mothers with normal PAPP-A was higher than other mothers (86.3%, P = 0.04). The frequency of preeclampsia in recent pregnancies in mothers with normal PAPP-A was significantly lower than other mothers (p < 0.001) and the frequency of abortions in recent pregnancies in mothers with PAPP-A less than 0.5 was significantly higher than mothers with normal or elevated PAPP-A (p < 0.001). Conclusion: Mothers with low PAPP-A levels are more likely to have poor pregnancy outcomes such as abortion, pre-term labor, and preeclampsia