Quality of life after cesarean and vaginal delivery

Objective: Cesarean rates in recent decades have been increasing and a number of studies have shown that cesarean increases maternal morbidities. The aim of this study is to compare the quality of life after cesarean and vaginal delivery. Methods: This prospective study was carried out on 356 pregnant women visiting urban health centers in Shahroud City, Northeast Iran, in 2011. The subjects completed the quality of life questionnaire in the third trimester of pregnancy and at 8 weeks postpartum. Results: In primiparas, the mean global QOL scores for the cesarean and vaginal delivery groups were 67.65±12.7 and 72.12±11.8, respectively. Also, the scores for the physical, psychological and social domains of QOL as well as the global score of QOL were higher in the vaginal delivery group than the cesarean group (p<0.05). In the case of primiparas, multiple regression analysis revealed that after adjusting for education, desirability of pregnancy and the General Health Questionnaire score, the delivery type remained as a predictor of the scores for the physical (R2=1.7%; B=-3.826; p=0.031; CI [-7.301, -.350]) and social (R2=2.5%; B=-5.708; p=0.017; CI [-10.392, -1.023]) domains of QOL and the global QOL score (R2=2.6%; B=-4.065; p=0.006; CI [-6.964, -1.164]). While multiparas, there was no relationship between QOL and type of delivery. Conclusion: In this sample of low-risk women, cesarean negatively affected the QOL of primiparas. More studies with larger sample sizes should be conducted to examine the effects of cesarean on QOL in both primiparas and multiparas within a shorter period after delivery. © OMSB, 2013

Validation of the World Health Organization-5 well-being index; assessment of maternal well-being and its associated factors

Objective: The aim of this study was to validate the World Health Organization-5 Well-Being Index (WHO-5) in a sample of pregnant Iranian women, to explore the changes in maternal well-being from pregnancy to postpartum, and to determine the factors associated with maternal well-being. Materials and Methods: This study included 341 pregnant women that presented to healthcare centers affiliated with Shahroud University of Medical Sciences, Iran, in 2011. The participants completed the General Health Questionnaire (GHQ-28) and Farsi version of WHO-5 during the third trimester of pregnancy and at 2 months postpartum. Results: Cronbach's alpha coefficient for WHO-5 items was 0.85. The correlation coefficient between WHO-5 and GHQ-28 was -0.64 (P < 0.001). Exploratory factor analysis yielded 1 factor with an eigen value equal to 3.15, which explained 63.1% of the total variance. Confirmatory factor analysis confirmed the 1-factor structure. The area under ROC curve was 0.82. A WHO-5 cut-off score of <50 exhibited optimal sensitivity (0.84) and specificity (0.59) for identifying psychological symptoms (GHQ-28 score ≥24). There was a significant difference between third trimester (58.4 ± 22) and postpartum (64.1 ± 22.3) mean WHO-5 scores (P < 0.001). Maternal level of education (OR = 1.130; 95% CI: 1.307, 1.232) was the only predictor of maternal well-being during third trimester. Breastfeeding difficulty (OR = 0.923; 95% CI: 0.882, 0.965) and maternal well-being scores during third trimester (OR = 1.038; 95% CI: 1.019, 1.058) were predictors of maternal well-being during the postpartum period. Conclusions: The Farsi version of WHO-5 was observed to be a reliable and valid instrument for screening psychological symptoms in pregnant Iranian women. The present findings show that maternal well-being improved following childbirth

Performance Evaluation of Hybrid Coding of Images Using Wavelet Transform and Predictive Coding

Image compression techniques are necessary for the storage of huge amounts of digital images using reasonable amounts of space, and for their transmission with limited bandwidth. Several techniques such as predictive coding, transform coding, subband coding, wavelet coding, and vector quantization have been used in image coding. While each technique has some advantages, most practical systems use hybrid techniques which incorporate more than one scheme. They combine the advantages of the individual schemes and enhance the coding effectiveness. This paper proposes and evaluates a hybrid coding scheme for images using wavelet transforms and predictive coding. The performance evaluation is done using a variety of different parameters such as kinds of wavelets, decomposition levels, types of quantizers, predictor coefficients, and quantization levels. The results of evaluation are presented

Survey of prevalence and types of bacterial contamination of mobile phones of personnel employed in major wards of educational hospitals in Yasuj

No Abstract

Human TLR1 Deficiency Is Associated with Impaired Mycobacterial Signaling and Protection from Leprosy Reversal Reaction

Toll-like receptors (TLRs) are important regulators of the innate immune response to pathogens, including Mycobacterium leprae, which is recognized by TLR1/2 heterodimers. We previously identified a transmembrane domain polymorphism, TLR1_T1805G, that encodes an isoleucine to serine substitution and is associated with impaired signaling. We hypothesized that this TLR1 SNP regulates the innate immune response and susceptibility to leprosy. In HEK293 cells transfected with the 1805T or 1805G variant and stimulated with extracts of M. leprae, NF-κB activity was impaired in cells with the 1805G polymorphism. We next stimulated PBMCs from individuals with different genotypes for this SNP and found that 1805GG individuals had significantly reduced cytokine responses to both whole irradiated M. leprae and cell wall extracts. To investigate whether TLR1 variation is associated with clinical presentations of leprosy or leprosy immune reactions, we examined 933 Nepalese leprosy patients, including 238 with reversal reaction (RR), an immune reaction characterized by a Th1 T cell cytokine response. We found that the 1805G allele was associated with protection from RR with an odds ratio (OR) of 0.51 (95% CI 0.29–0.87, p = 0.01). Individuals with 1805 genotypes GG or TG also had a reduced risk of RR in comparison to genotype TT with an OR of 0.55 (95% CI 0.31–0.97, p = 0.04). To our knowledge, this is the first association of TLR1 with a Th1-mediated immune response. Our findings suggest that TLR1 deficiency influences adaptive immunity during leprosy infection to affect clinical manifestations such as nerve damage and disability

The needs of parents of preterm infants in Iran and a comparison with those in other countries: A systematic review and meta-analysis

Context: Proper accountability to needs of preterm infants� parents requires recognition of these needs and how they change in different conditions. The aim of this study was to assess the needs of parents of preterm infants in Iran, as compared to those in other regions in the world. Evidence Acquisition: A search of Iranian databases (IranMedex, Magiran, and SID) and international resources (PubMed, Scopus, and Google Scholar) was conducted, with no time limitations, to 5 October 2014. Using standard tools, all quantitative studies that considering the parental needs of preterm infants and parental support were extracted. The STROBE checklist was used for the evaluation of the studies. Thirty-one studies were extracted in the qualitative evaluation, of which 17 were included in the metaanalysis. The variance between the studies was analyzed using tau-squared (Tau2) and review manager 5 software. Results: The results obtained using the nurse-parent support tool (NPST) showed that mothers considered that all the fields of support were of great importance. The parental needs in Iran were similar to those of parents in other regions worldwide. However, the mean score for Iranian parents� assessment of the support they received was 2.20 ± 0.06, whereas it was 3.84 ± 0.72 for other countries. The mean scores for parents� assessment of the provision of emotional, informational appraisal, and instrumental support in Iran were 1.73±0.06, 2.1±0.06, 1.54±0.6, and 3.44±0.04, respectively, compared to 3.18±1.34, 4.11±0.5, 4.26±0.18, and 4.51±0.14, respectively, in other countries. Conclusions: Parents always prefer the priorities of their babies to their individual needs. Given the lower scores for the parental assessment of received support in Iran, it is important to focus on these specific items in providing interventions to meet the needs of Iranian parents. © 2016, Growth & Development Research Center

Development of a support system for parents of premature infants

Background: The concept of family-centered care is increasingly being recognized at the international level. Objectives: Development of a support system for parents of premature infants (PPI), based on family-centered care and scientific evidences. Methods: The method is based on four key steps. 1) Explaining parents� needs, including comprehensive review of quantitative studies, meta-synthesis of qualitative studies conducted in Iran by search of Iranian databases (IranMedex, Magiran, and SID) and international resources (PubMed, Scopus, and Google Scholar) and comparative study. 2) A comprehensive review to identify effective interventions in supporting PPI and ranking interventions. 3) Designing a model to support PPI. 4) Evaluating designed system for supporting the PPI. Results: The results of this study identified five critical steps which the PPI experienced and 14 effective interventions to support them. Preconception: care before the next pregnancy; prenatal: preparing parents to see their baby for the first time, supporting parents in breastfeeding (BF), kangaroo care (KC) and infant massage; neonatal: spiritual self-care, individualized behavioral and developmental care programs, using scales to assess infant�s behavior, supporting parents in BF, KC and infant massage, support forums for parents, relieving parents� stress, sharing information and communication, family nurture interventions, supporting parents in transferring between neonatal units (NU), facilitating collaborative care in NU; discharge: discharge planning, support forums for parents, sharing information and communication and home: home support programs, individualized behavioral and developmental care programs, supporting parents in BF, KC and infant massage. Support forums for parents, sharing information and communication. Conclusions: Our proposed system provides a parent-centered system which can be implemented to provide high-quality care for PPI. © 2017, Iranian Journal of Pediatrics

The need for support and not distress evoking: A meta-synthesis of experiences of iranian parents with premature infants

Context: Proper accountability to needs of premature infants' parents requires recognition of these needs and how they change in different conditions. Objective: This Meta-synthesis was conducted to understand the needs of Iranian parents with premature infants through their experiences in order to promote family-centered care. Data Sources: The search was conducted through the Iranian database (Iran Medex, Magiran, SID) and international resources (PubMed, Scopus, Google Scholar), without time limitation to April 12, 2015. Study Selection: The inclusion criteria for this study included the qualitative studies conducted in Iran on parents with premature infants. Consolidated criteria for reporting qualitative studies (COREQ) were used to assess the quality of articles. Data Extraction: This study is a meta-synthesis of 16 qualitative studies based on Noblit and Hare's (1988) methodology. Results: The meta-synthesis presented 5 correlated metaphors derived from 13 categories and 78 integrated codes. The metaphors indicated the most important needs of parents who have premature infants for emotional, instrumental, spiritual, appraisal, informational, and communicational support. In most cases, these needs overlapped with blur boundaries. The categories included: cultural challenges of parental role, parental development versus psychological stress, psychological stress stimuli, economic challenges of parental role, physical irritation, the need for family-centered care, the need for policy making regarding the constant presence of parents in the NICU, spiritual prosperity vs. spiritual alienation, spiritual self-care vs. spiritual self-harm, guided participation in caring for the infant, the efforts to meet parental role, informational challenges of parents, and informationalcommunicational supports. Conclusions: This Meta-synthesis provided a better understanding of the experiences of Iranian parents with premature infants and different areas of their needs. These findings could be used to design a comprehensive support system for such parents, which incorporate a holistic view of patient concerns, including religion and spirituality. © 2017, Iranian Journal of Psychiatry and Behavioral Sciences