Blind Mothers’ Experiences of Marginalization: A Hermeneutic Phenomenological Qualitative Study

Introduction: Mothering is a precious art with many intricacies. When women experience the phenomenon of mothering, they become vulnerable, and face many challenges. It creates worst conditions, if this experience is combined with a disability such as blindness. This study aimed to determine blind mothers’ experiences of marginalization. Method: The approach used in this study was hermeneutic phenomenology. Sampling was carried out using targeted and snow balling method. Face-to-face interviews were conducted with nine congenitally blind mothers who had child under the age of 8 years old. The interviews were recorded and transcribed verbatim. Interviews continued until data saturation. van Manen method was used for all steps of the study including data collections, data analysis, and interpretation and reporting the findings. Data analysis was performed using MAXQDA software. Results: From 479 initial codes, the main theme of "hermit inevitable", and subthemes of "feelings of shame", "a sense of discrimination", and "obligation in loneliness" were emerged. Conclusion: Blind mothers’ perception of themselves was to be marginalized, and they suffered from shame feeling, discrimination, lack of support, and obligation in loneliness. Blindness affects mothering, and blind mothers are in a unique situation. Keywords: Mothers, Blindness, Hermeneutics, Qualitative research, Experienc

The Effect of Vitamin D Supplementation on Anthropometric Indices and Total Testosterone in Women with Polycystic Ovary Syndrome Treated with Low Calorie Diet: A Randomized Clinical Trial

Background and Objectives: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in reproductive age women. In the present study, the effect of weight loss diet and vitamin D supplementation was investigated on total testosterone, anthropometric indices, and body composition in patients PCOS.   Methods: In this controlled clinical trial, 60 PCOS women with vitamin D deficiency, were randomly received vitamin D3 supplementation orally at the dose of 50000IU/week along with weight-loss intervention or one placebo/week along with weight-loss diet for 12 weeks. At the beginning and the end of the study, indices, such as anthropometric, body composition, serum level of 25-hydroxyvitamin D3, and total testosterone, were measured using parametric and non-parametric tests.   Results: After a 12-week intervention, the median of serum 25-hydroxyvitamin D3 significantly increased from 18.5 to 42.69ng/ml in vitamin D group compared to the placebo group (p<0.001). Moreover, the mean of weight, body mass index (BMI), Waist circumference, hip circumference, waist to hip ratio, and fat mass significantly decreased in both groups, but was not different between the two groups. The mean of total testosterone decreased from 0.7 to 0.5ng/ml in vitamin D group, which was not statistically significant.   Conclusion: According to the results of this study, vitamin D supplementation in combination with low-calorie diet had no effect on total testosterone

Multi-Drug Resistance against Second-Line Medication and MicroRNA Plasma Level in Metastatic Breast Cancer Patients

Background: Circulating microRNAs (miRNAs) can help to predict the chemotherapy response in breast cancer with promising results. The aim of the present study was to investigate the relationships between the miR-199a, miR-663a, and miR-663b expression and chemotherapy response in metastatic breast cancer patients.Methods: This study is a case-control study performed at Yasuj University of Medical Sciences (2018-2021). The expression levels of miR-663a, miR-663b, and miR-199a in the serum of 25 patients with metastatic breast cancer versus 15 healthy individuals were determined by the real-time polymerase chain reaction method. The response to treatment was followed up in a 24-month period. All patients were treated with second-line medications. Two or more combinations of these drugs were used: gemcitabine, Navelbine®, Diphereline®, Xeloda®, letrozole, Aromasin®, and Zolena®. Statistical analyses were performed in SPSS 21.0 and GraphPad Prism 6 software. The expression levels were presented as mean±SD and analyzed by Student’s t test.Results: The results and clinicopathological features of patients were analyzed by t test. The statistical analysis showed that miR-663a expression was related to human epidermal growth factor receptor 2 (HER2) status and was significantly lower in the HER2+ than HER2- group (P=0.027). Moreover, the expression of miR-199a and miR-663b was significantly correlated with the response to treatment, in which the expression of miR-199a was higher in the poor-response group (P=0.049), while the higher expression of miR-663b was seen in the good-response group (P=0.009).Conclusion: These findings state that the high plasma level of miR-199a and the low plasma level of miR-663b may be related to chemoresistance in patients with metastatic breast cancer

Empagliflozin in Patients with Chronic Kidney Disease

Background The effects of empagliflozin in patients with chronic kidney disease who are at risk for disease progression are not well understood. The EMPA-KIDNEY trial was designed to assess the effects of treatment with empagliflozin in a broad range of such patients. Methods We enrolled patients with chronic kidney disease who had an estimated glomerular filtration rate (eGFR) of at least 20 but less than 45 ml per minute per 1.73 m(2) of body-surface area, or who had an eGFR of at least 45 but less than 90 ml per minute per 1.73 m(2) with a urinary albumin-to-creatinine ratio (with albumin measured in milligrams and creatinine measured in grams) of at least 200. Patients were randomly assigned to receive empagliflozin (10 mg once daily) or matching placebo. The primary outcome was a composite of progression of kidney disease (defined as end-stage kidney disease, a sustained decrease in eGFR to &lt; 10 ml per minute per 1.73 m(2), a sustained decrease in eGFR of &amp; GE;40% from baseline, or death from renal causes) or death from cardiovascular causes. Results A total of 6609 patients underwent randomization. During a median of 2.0 years of follow-up, progression of kidney disease or death from cardiovascular causes occurred in 432 of 3304 patients (13.1%) in the empagliflozin group and in 558 of 3305 patients (16.9%) in the placebo group (hazard ratio, 0.72; 95% confidence interval [CI], 0.64 to 0.82; P &lt; 0.001). Results were consistent among patients with or without diabetes and across subgroups defined according to eGFR ranges. The rate of hospitalization from any cause was lower in the empagliflozin group than in the placebo group (hazard ratio, 0.86; 95% CI, 0.78 to 0.95; P=0.003), but there were no significant between-group differences with respect to the composite outcome of hospitalization for heart failure or death from cardiovascular causes (which occurred in 4.0% in the empagliflozin group and 4.6% in the placebo group) or death from any cause (in 4.5% and 5.1%, respectively). The rates of serious adverse events were similar in the two groups. Conclusions Among a wide range of patients with chronic kidney disease who were at risk for disease progression, empagliflozin therapy led to a lower risk of progression of kidney disease or death from cardiovascular causes than placebo