Diagnostic Value of Risk Nomogram for the Prediction of Postpartum Hemorrhage Following Vaginal Delivery

Background: Postpartum hemorrhage (PPH) is considered as one of the major causes of maternal mortality worldwide. The most effective risk factors have been suggested in various studies on risk nomogram for the prediction of PPH. Aim: This study aimed to determine the diagnostic value of the risk nomogram for the prediction of PPH. Method: This study was performed prospectively using diagnostic methods on 600 women admitted to Omolbanin Hospital, Mashhad, Iran, from May to October 2017. The researcher measured and recorded the loss of blood volume in mothers using plastic blood collection bags and pads within 4 h after delivery. Subsequently, risk nomogram was completed for each study sample and the probability score for PPH was calculated by the researcher’s assistants. The obtained data were analyzed in SPSS software (Version 25). Ultimately, the receiver operating characteristic (ROC) curve of risk nomogram was plotted in this study. Results: The PPH occurred in 33.3% (n=200) of deliveries in this study. The area under the ROC curve was estimated at 81.2%. The point of 0.1 with 85.5% sensitivity and 51.5% specificity was also selected as the proposed cut-off point for this nomogram. Implications for practice: According to the results, the risk nomogram was considered as an appropriate method for the prediction of PPH. Therefore, it was recommended as a simple and noninvasive approach in childbirth for the prediction of PPH

The Impact of a High-risk Sexual Behavior Prevention Program via Mobile Application on Sexual Knowledge and Attitude of Female Students

Background & aim: The prevalence of high-risk sexual behaviors among different social groups has been considered as a serious health-related threat in recent years. Given the importance of raising awareness and health among the youth and preventing high-risk behaviors, the present study was conducted to investigate the effect of a high-risk sexual behavior prevention program via mobile application on sexual knowledge and attitude in undergraduate female students. Methods: This quasi-experimental study was conducted among two groups of female students with a pretest-posttest design. A total number of 200 undergraduate eligible female students of Mashhad University of Medical Sciences, Mashhad, Iran were recruited in 2016. The subjects were randomly assigned to an intervention group receiving education through a mobile application (N=100) and a control group (N=100). To collect data a self-structured demographic questionnaire as well as sexual knowledge and attitude questionnaires were used. In the intervention group, the participants received a prevention program through a mobile application. Knowledge and attitude towards high-risk sexual behaviors were assessed and compared before and two weeks after the intervention. To analyze the data, paired t-test, independent t-test, Mann-Whitney U test, Wilcoxon signed-rank test, and Chi-square test were run in SPSS, version 16. Results: The mean scores of sexual knowledge and attitude after education increased compared to the pre-intervention stage (p0.05). Conclusion: The study results reflected the favorable effect of education via mobile application. The implementation of high-risk sexual behavior prevention programs using mobile applications could enhance sexual knowledge and attitude in students and promote community healt

The Relationship of Gender Role Attitude and Division of Household labor with Couples' Perceived justice

Background & aim: Given the advancements in science, technology, and cultural globalization, Iranian families has changed in several aspects affecting individual’s perception of justice in division of household labor. Therefore, we sought to evaluate the correlation of gender role attitude and household labor division with perceived justice in couples. Methods: The present correlational study was conducted in 180 couples visiting healthcare centers of Mashhad, Iran, in 2014. The participants were selected through the three-stage cluster sampling method. Data collection tools included questionnaires of gender role attitude, participation in household labor, and perceived justice. Spearman rho and Pearson correlation coefficient were run in SPSS, version 16. Results: A significant correlation was seen between women’s gender role attitude with their involvement in household labor and perceived justice (P=0.04, P=0.03, respectively). But there was no correlation between their involvement in household labor and perceived justice (P=0.83). There was no correlation between men’s gender role attitude and their involvement in household labor (P=0.61), whereas their gender role attitude was correlated with perception of justice (P=0.01, r=-0.13). There was also a direct correlation between male involvement in household labor and perceived justice (P=0.00, r=0.19). Conclusion: Most employed women despite having modern gender role attitudes, had still more involvement in household labor. Almost half of men who had traditional gender role attitudes, reported appropriate involvement in household labor. Men with more involvement in household labor had a higher perception of justice

Evaluation of the diagnostic value of a Modified Liquid-Based Cytology using OralCDx Brush in early detection of oral potentially malignant lesions and oral cancer

Objectives: To determine diagnostic value of modified Liquid Based Brush Biopsy technique. Study design: 26 oral premalignant and malignant lesions in 25 patients (12 females; 54.23±19.77 years and 13 males; 53.77±15.43 years) underwent Modified (Liquid Based) Brush Biopsy and scalpel biopsy simultaneously from the same area. Results: There were 16 positive and 10 negative brush biopsy results, with no inadequate readings. Histological findings were compatible with oral leukoplakia(n=5)with dysplasia, Oral lichen planus and lichenoid reaction(n=7) (with or without dysplasia)oral squamous cell carcinoma(n=11),verrucous carcinoma(n=1) and granular cell tumors( n=2). Sensitivity, specificity, positive predictive value, negative predictive value, positive diagnostic likelihood ratio(LR+) and negative diagnostic likelihood ratio(LR-) were 88.8%,100%,100% , 80%, infinity and 0.11 respectively(no false positive results). Conclusion: It is the first attempt to do LBC (liquid based cytology) with a specialized oral brush. Our results show that modified technique is a useful tool for screening of oral premalignant and malignant lesions

Comparison of the Effect of Pressure on Bladder-GV20 and Gallbladder-GV20 on Labor Pain Intensity among the Primiparous Women: A Randomized Clinical Trial

Background: The cycle of pain, fear, and anxiety may lead to prolonged labor and cesarean section. Acupressure is one of the methods for pain relief. Aim: Therefore,this study aimed to compare the effect of acupressure on bladder-GV20 and gallbladder-GV20 points on the labor pain in primiparous women. Method: This randomized clinical trial was conducted on 158 primiparous women, who referred to the Um Al-Benin Specialized Women Hospital, Mashhad, Iran in 2017. The first stage of labor included five and four pressure cycles on acupressure points in bladder and gallbladder in the intervention groups 1 and 2, respectively. In the second stage of labor one pressure cycle on the same points were completed. The control group only received the routine cares. The duration of uterine contractions was assessed by touching the uterus apex. Moreover, the pain intensity was evaluated by the visual analog scale. All the data were analyzed by the SPSS version 25 Results: The mean pain intensity in both stages of the intervention groups was significantly different from the control group and was significantly lower in the gallbladder group (

The Concurrent Validity of Using Simulated Patient and Real Patient in Communication Skills Assessment of Medical Students

Background & Objective: Communication skills assessment requires the use of valid instruments. The present study has done to investigate concurrent validity of the simulated patient meaning relationship between test results by the simulated or real patient and possibility to generalize the results by simulated patient and in simulated environment for real patient and in bedside. Methods: In this correlation study, 32 medical externships were enrolled by purposive sampling method. The students were divided randomly into two equal and homogeneous groups. Using crossover design, first group were assessed by real patient initially and then, simulated patient and second group, were measured conversely. Communication skills assessment was done using a checklist retrieved from Calgary-Cambridge interview skills checklist. The data were analyzed using descriptive and analytical statistics. Results: In first assessment, comparing scores by simulated and real patient in first group, second group and total students showed significant differences. In second assessment between two groups, the statistics results was not significant with very minor differences (P = 0.064). There were positive correlation between scores of total students by simulated and real patient (r = 0.63). Conclusion: According to the results, communication skills of each student in simulated position cannot be generalized to real situation and cannot be claimed that simulated patient can be used instead of real patient. Keywords Communication skills Assessment Concurrent validity Simulated patient Real patien

Assessment of the Relationship between Fear and Self-efficacy of Childbirth during Labor in Primipara Women

Fear of childbirth is an important and prevalent problem during pregnancy and delivery. Self-efficacy of childbirth is one of the factors playing an important role in the fear of delivery. This study aimed to determine the relationship between the fear and self-efficacy of childbirth during labor in primipara women. This descriptive and analytical study was conducted on 100 primipara women in Ommolbanin Hospital, Mashhad, Iran, during 2017. Data were analyzed in SPSS software using descriptive statistics and Pearson’s correlation coefficient. According to the results, the mean scores of fear and self-efficacy of delivery were reported to be 48.9±14.2 and 220.5±54.9, respectively. In addition, there was a reverse association between the scores of fear of childbirth and self-efficacy of delivery using Pearson’s results (r=-0.44,

Haplotype analysis of hemochromatosis gene polymorphisms in chronic hepatitis C virus infection : A case control study

Funding/Support: This study was financially supported by the research council of Mashhad University of Medical Sciences, Mashhad, Iran (Grant No. 901012).Peer reviewedPublisher PD

Comparison of Clinical and Radiologic Outcome of Adolescent Idiopathic Scoliosis Treated with Hybrid Hook-Screw Instrumentation versus Universal Clamp System

Background. In surgical treatment of adolescent idiopathic scoliosis (AIS), hybrid universal clamp system has been used by some authors. We aimed to compare the clinical and radiologic outcome of hybrid universal clamp with hybrid thoracic hook lumbar screw. Methods. A prospective study was performed on 56 consecutive patients with AIS, who had alternatively undergone a posterior spinal fusion and instrumentation with hybrid thoracic hook lumbar screw system (28 patients: group A) and hybrid universal clamp system (28 patients: group B) between June 2006 and January 2014 at Imam Reza University Hospital and had been followed up for more than two years. The comparison was according to radiographic changes, operative time, intraoperative blood loss, complications, and Scoliosis Research Society (SRS-22) outcome scores. Results. The preoperative mean curve Cobb angle was 58°±7° (42°–74°) in group A and 60°±9° (46°–75°) in group B. The mean final coronal curve correction was 60.4% and 75.5% in groups A and B, respectively (P=0.001). Postoperative SRS outcome scores were also comparable. Conclusion. Universal clamp instrumentation had a significantly better curve correction and lower complication rate compared with hybrid thoracic hook lumbar screw. Both instrumentation methods had similar operative time, intraoperative blood loss, and postoperative SRS outcome scores

Age-related Variation in Expression of Breast Cancer Tumour Markers in Iranian Patients

Background: There are believed to be several risk factors affecting the prognosis of breast cancer through their effect on the growth rate of tumour. In the present study, we investigated estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), Ki-67, and tumor protein P53 (TP53) as well-known biomarkers, particularly in breast cancer prognosis, associated with age. Method: In a case-control study, 406 breast cancer patients were considered retrospectively. In order to extract the clinical and pathologic data, we employed the patients’ records. The extracted information was compared between two groups: for patients under 40 (group I) and above 40 years of age (group II). Herein, the researchers performed statistical analysis using SPSS Ver16. Results: The most prevalent type of cancer in both groups was found to be invasive ductal carcinoma. The major method of treatment was modified radical mastectomy. According to our observations, grade 3 breast cancer was more common in group I. Lymph node involvement significantly increased in group I, while oestrogen and progesterone receptor expressions were less in this group. HER2, TP53, and Ki-67 oncogenes were overexpressed in group I compared with group II. Conclusion: Expression of HER2, TP53, and Ki-67 biomarkers and a reduction in the number of hormonal receptors in younger patients (<40YO) indicated that breast cancer might be more invasive in younger women with breast cancer and therefore, they might have poorer prognosis and less favourable outcomes