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Marital Satisfaction in Postpartum Women: The Role of Personality, Body Image Satisfaction, Anxiety, and Sexual Function
No full textBackground The postpartum period is considered a vulnerable and stressful period for many women due to various hormonal, physical, and psychosocial changes, such as adapting to parental rules, changes in body and self-image, loss of autonomy, breastfeeding, and taking care of the baby.Objective This study aimed to test a conceptual model considering the interrelated role of anxiety, body image satisfaction, sexual function, type of personality, income, and education on women's marital satisfaction. Also it also aimed to test the mediating role of sexual function and anxiety.Methods In this cross-sectional study, 447 lactating women were recruited from January to April 2019. Women answered some questionnaires including a socio-demographic checklist, female sexual function index (FSFI), Body Self-Relation Questionnaire (BSRQ), the Enrich Marital Satisfaction, and the NEO Personality Inventory (NEO PI-R). Data were analyzed using the descriptive test, and Path analysis was done with LISREL software.Results Results show that sexual function (beta= 0.44), anxiety (beta= -0.26), and educational level (beta= 0.47) are the main predictors of marital satisfaction (dependent variable). Sexual function and anxiety were two main mediators; variables, such as anxiety (beta= -0.35), body image satisfaction (beta= 0.19), and extraversion personality (beta= 0.19) (independent variables), with an effect through sexual function, can impress marital satisfaction indirectly.Conclusion Identifying relationships between anxiety, educational level, sexual function, anxiety, body image, and personality with the quality of life of postpartum women highlights the importance of designing interventions to improve marital satisfaction. Given these relationships, it is recommended that health professionals educate women about body changes during postpartum and find ways to improve mothers' marital satisfaction
Association of cardiac troponin I level with in-hospital and late mortality in dialysis patients
No full textBackground: Cardiovascular diseases (CVDs) are highly prevalent among the end-stage renal disease (ESRD) patients. Prognostic value of cardiac troponin I (cTnI) in patients with asymptomatic ESRD is less conclusive. This study was an observational study to evaluate correlation of first admitted cTnI level with early and late (during 6 months) hospitalization and mortality of ESRD patient admitted due to non-acute coronary and non-heart failure causes in ESRD patients. Materials and Methods: In this prospective observational study, 460 dialysis patients without overt CVD who were admitted at two university hospital were included and followed during 6 months. Patients' demographic information and laboratory investigations including cTnI level and cause of admission were recorded. The association between cTnI level with in-hospital and late mortality was evaluated. Results: cTnI level was higher in female (35.9), hemodialysis patients (28.1), and patients with permanent catheter vascular access (29.4). There were significant differences in level of triglyceride (TG), low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDL) cholesterol between patients with normal and abnormal cTnI levels (P < 0.05). Patients with abnormal cTnI levels had higher level of TG and LDL cholesterol and lower level of HDL cholesterol. cTnI levels were associated with higher in-hospital and 6-month follow-up mortality rate. In logistic regression analysis, only female gender (odds ratio OR =1.89, confidence interval CI =1.22-3.076) and TG (OR = 1.007, CI = 1.003-1.01) were positively and HDL cholesterol level (OR = 0.994, CI = 0.98-0.99) was negatively associated with increased cTnI level. cTnI level was associated with early (OR = 4.81, CI = 1.64-14.89) and late (OR = 4.31, CI = 1.61-10.96) mortality. Conclusion: Although in this study, cTnI level is not directly associated with cardiovascular disorders and admission and readmission causes, it is a strong predictor of early and late mortality
Comparison of the effects of medication error encouragement training and low-fidelity simulation on the medication safety competence and knowledge of nursing students: A quasi-experimental study
No full textIntroduction: Medication safety is a key indicator of healthcare quality and an essential component of patient safety. Medication errors threaten medication safety, causing harm to patients and leading to psychological and financial consequences for both patients and healthcare providers. There has been a significant increase in medication errors among nursing students. Among the main causes of medication errors are insufficient education, which leads to a lack of knowledge and competency in safe medication administration. Medication error encouragement training and low-fidelity simulation are among the new educational methods in the field of safe medication administration training. This study aimed to compare the effects of two methods-medication error encouragement training and low-fidelity simulation-on the knowledge and competency of medication safety among nursing students. Methods: This study is a quasi-experimental, two blinded, two-group design conducted in 2023. Sixty-four thirdyear nursing students were selected through convenience sampling and randomly assigned to control and intervention groups. The students' medication safety knowledge was assessed through self-report, and their medication safety competence was evaluated using a scenario as a pretest. Subsequently, one group underwent medication error encouragement training, while the other group experienced low-fidelity simulation. Afterward, the participants' medication safety competence was assessed post-intervention using a different scenario from the pretest, with their performance observed and their medication safety knowledge score self-reported. Data collection was done through the Medication Safety Critical Element Checklist and Medication Safety Knowledge Assessment. Data analysis was performed using SPSS version 16, with a significance level set at 0.05. Results: The independent sample t-test revealed no significant difference between the knowledge and medication safety competence scores of the two groups before the intervention (P > 0.05). The paired sample t-test indicated a significant increase in the scores of knowledge and medication safety competence for both groups after the intervention (P 0.05). Conclusion: The study results indicate that both medication error encouragement training and low-fidelity simulation play a significant role in enhancing the knowledge and medication safety competence of nursing students. Therefore, it is recommended that nursing educators incorporate these two methods in medication safety training
External ureteral involvement as a result of ovarian cancer initially suspected as endometriosis leading to the diagnosis of squamous cell carcinoma
No full textOvarian squamous cell carcinoma SCC is a rare and aggressive malignancy that can mimic benign gynecological disorders, often leading to diagnostic delays and suboptimal management. Ureteral obstruction and subsequent hydroureteronephrosis due to extrinsic compression are atypical initial presentations of ovarian SCC. A 39-year-old female presented with nausea, vomiting, anuria, and bilateral hydroureteronephrosis, initially suspected to be endometriosis. Given the severity of acute kidney injury, emergent hemodialysis was initiated. Imaging demonstrated bilateral distal ureteral obstruction, necessitating percutaneous nephrostomy and subsequent referral for definitive management. Intraoperative findings revealed extensive fibrosis and adhesions, warranting left salpingooophorectomy and bilateral ureteroneocystostomy with double-J stent placement. Histopathological analysis confirmed ovarian SCC with direct ureteral invasion and hepatic metastases. Despite surgical intervention and palliative systemic therapy, the disease exhibited rapid progression, ultimately culminating in patient mortality. This case underscores the diagnostic complexities of ovarian SCC presenting with obstructive uropathy and highlights the necessity of maintaining a high index of suspicion for malignancy in patients with bilateral hydroureteronephrosis of unclear etiology. A timely, multidisciplinary approach integrating urological and oncological expertise is paramount in optimizing clinical outcomes
Transfer Learning and Neural Network-Based Approach on Structural MRI Data for Prediction and Classification of Alzheimer's Disease
No full textBackground: Alzheimer's disease (AD) is a neurodegenerative condition that has no definitive treatment, and its early diagnosis can help to prevent or slow down its progress. Structural magnetic resonance imaging (sMRI) and the progress of artificial intelligence (AI) have significant attention in AD detection. This study aims to differentiate AD from NC and distinguish between LMCI and EMCI from the other two classes. Another goal is the diagnostic performance (accuracy and AUC) of sMRI for predicting AD in its early stages. Methods: In this study, 398 participants were used from the ADNI and OASIS global database of sMRI including 98 individuals with AD, 102 with early mild cognitive impairment (EMCI), 98 with late mild cognitive impairment (LMCI), and 100 normal controls (NC). Results: The proposed model achieved high area under the curve (AUC) values and an accuracy of 99.7, which is very remarkable for all four classes: NC vs. AD: AUC = 0.985, EMCI vs. NC: AUC = 0.961, LMCI vs. NC: AUC = 0.951, LMCI vs. AD: AUC = 0.989, and EMCI vs. LMCI: AUC = 1.000. Conclusions: The results reveal that this model incorporates DenseNet169, transfer learning, and class decomposition to classify AD stages, particularly in differentiating EMCI from LMCI. The proposed model performs well with high accuracy and area under the curve for AD diagnostics at early stages. In addition, the accurate diagnosis of EMCI and LMCI can lead to early prediction of AD or prevention and slowing down of AD before its progress
Applications for the management of Attention Deficit Hyperactivity Disorder: a systematic review
No full textBackground Various interventions are available for managing Attention Deficit Hyperactivity Disorder (ADHD), including educational strategies and training programs. Recently, there has been a notable increase in the use of programs and apps as innovative tools to assist with ADHD management. This study aims to provide insights into the possibility of app-based therapies as a supplemental tool for ADHD care by analyzing the indicated advantages and supporting data. Methods This systematic review was conducted until May 4, 2024, in several electronic databases, PubMed, MEDLINE, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials. In addition, we conducted a comprehensive search for relevant grey literature. The studies included trials, quasi-experimental studies, and observational studies on using apps to control ADHD. This includes studies that were published in English. Results A review of 14 studies investigated the effectiveness of ADHD applications. Several applications monitored symptoms and enhanced cognitive function. Healthcare providers enhanced communication using the AKL-X01 app to monitor and record symptoms. The FOCUS ADHD app was well accepted but did not improve treatment compliance. The Sensory Diet App, known for its user-friendly interface, effectively alleviated symptoms associated with ADHD. BRUSH DJ enhanced dental hygiene and concentration on toothbrushing. Conclusion Apps can potentially be adjunctive instruments for treating ADHD. Nevertheless, further study is required to validate their effectiveness over a long period and enhance their incorporation into complete treatment strategies for ADHD. Systematic review registration identifier CRD42024523528 (PROSPERO)
Fracture Resistance of Fiber-Reinforced vs. Conventional Resin Composite Restorations in Structurally Compromised Molars: An In Vitro Study
No full textObjective: The aim of this study was to evaluate reinforcing effect of different fiber-reinforced resin composites for restoring structurally compromised molars compared to conventional resin composite. Methods and Materials: Sixty healthy human third molars were randomly divided into six groups (n = 10). In G1 to G4, wide mesio-occluso-distal (MOD) cavities with an occlusal depth of 4 mm and proximal boxes with a width of 2/3 of buccolingual distance were prepared. In G5, after preparation of MOD cavities, 2 mm cusp reduction was made. The samples of G6 were remained intact (control). In G1 and G5, the conventional resin composite (G-ae nial Posterior), and in G2, short fiber-reinforced resin composite (SFRC: EverX Posterior) were used. In G3 and G4, the Ribbond fibers were applied on base of cavity in buccolingual and cross-sectional direction, respectively, and followed by conventional resin composite restoration. After 24 h maintaining in distilled water at room temperature, fracture resistance of restored teeth was tested with a crosshead speed of 0.5 mm/s and fracture patterns were also evaluated by stereomicroscope (favorable: above cementoenamel junction (CEJ) and unfavorable: below CEJ). The data was analyzed using Shapiro-Wilk, one-way ANOVA, and post hoc Tukey's HSD tests. Results: The highest fracture strength was obtained in G2 (4051.4 +/- 1293.9 N), which was significantly greater than G3 (2886.6 +/- 720.4 N; p = 0.005) and G5 (2949.3 +/- 307.5 N; p = 0.010). No statistically significant difference was observed between other study groups. The greatest percentage of favorable fracture was recorded in G6 (70) and G2 (60). Conclusion: The reconstruction of severely weakened molar teeth with SFRC or incorporating of polyethylene fibers in cross-sectional direction on base of resin composite restoration improved fracture strength and favorably affected fracture modes in comparison to conventional posterior resin composite with or without cusp coverage
Investigating the Safety of Fampridine in Patients with Different Stages of Multiple Sclerosis
No full textBackground:Fampridine is the only drug approved by the US Food and Drug Administration (FDA) for people with multiple sclerosis (MS) to improve their movement and has exhibited a clinically significant improvement in gait function in a subset of MS patients with Expanded Disability Status Scale (ESDSS) from 4 to 7. Nevertheless, this drug has been reported to possess some adverse effects (AEs) like seizure because of its pharmacological features. The aim of this study was to evaluate the incidence rate of post-medication side effects (SEs) of fampridine in MS patients.Methods:This prospective cohort study includes MS patients aged between 18 and 65 years, referred to the neurology clinic of Kashani Hospital from April 2022 to October 2022, all with administration of fampridine (10 mg tablet twice daily according to the product specifications). Safety in these patients was monitored through monthly SEs checklist questions during 6 months of screening. SPSS version 18 was used to analyze the data of this study.Results:From 319 participants screened at baseline, 254 patients with MS, including 127 relapsing-remitting multiple sclerosis (RRMS), 101 secondary progressive multiple sclerosis (SPMS), and 26 primary progressive multiple sclerosis (PPMS), were included in the study. The most observed AEs in SPMS and RRMS patients were dry mouth (13.9 vs. 15) and insomnia (12.9 vs. 11), respectively. Urinary tract infection (UTI) (11.5) and stomachache (11.5) were the most common SEs in PPMS patients. The most severe complication of the patients was back pain, while digestive complications were less severe. Also, insomnia and UTI were the patients' most persistent SEs.Conclusions:The drug seems to be safe and well tolerated, as the SEs were mild and transient and they were consistent with most of the previous studies focusing on this medication
Recent advances in improved efficacies of gold nano-formulations in treatment of skin cancer: a systematic review
No full textSkin cancer is the commonest malignancy for the population. Conventional skin cancer treatments include chemotherapy and surgery, but a large number of the chemotherapeutic drugs applied currently have undesirable possessions. The aim of this study is to provide a complete and acute assessment of the antitumor capability of gold nano-formulations in skin cancer as a new and more effectual delivery system for targeted therapy. In this systematic review, we conducted our first search in December 2021. In order to find related studies, 3 databases PubMed, Scopus and ScienceDirect. In order to maintain comprehensiveness in the search, no time limit was considered in the search process and finally the information obtained from the search was transferred to the information management software (EndNote). In order to maximize the number of articles that were related to our topic, a list of references identified in relevant articles was also manually searched and reviewed. Our final search was updated in late December 2021. There was evidence for a correlation between anticancer activities and treatment with gold nano-formulations. Additionally, studies shown that specific functionalization of the gold nanoparticles (Au NPs) which increase targetability to specific populations of cells could increase the application of Au NPs to the effective delivery of drugs to tumor cells. Our study demonstrated that gold nano-formulations are possible candidates for skin cancer treatment and might provide additional support for the clinical use of these anticancer agents in the future
The association between maternal tobacco smoking during pregnancy and the risk of attention-deficit/hyperactivity disorder (ADHD) in offspring: A systematic review and meta-analysis
No full textIntroduction Maternal tobacco smoking during pregnancy is a significant public health concern with potential long-lasting effects on child development. ADHD, a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity, may be influenced by prenatal nicotine exposure. This systematic review and meta-analysis examine the association between maternal tobacco smoking during pregnancy and the risk of ADHD in offspring. Methods Following PRISMA guidelines, we searched databases including PubMed, Web of Science, Cochrane Central, Embase, Scopus, CINAHL, LILACS, SciELO, Allied and Complementary Medicine Database (AMED), ERIC, CNKI, HTA Database, Dialnet, EBSCO, LENS, and Google Scholar for studies up to November 1, 2024. We included peer-reviewed studies reporting quantitative effect size estimates for the association between maternal tobacco smoking and ADHD. Study quality was assessed using the Newcastle-Ottawa Scale (NOS). Results We identified 2,981 articles and included 55 studies (4,016,522 participants) in the analysis. The meta-analysis showed a significant association between maternal tobacco smoking during pregnancy and increased risk of ADHD in offspring (pooled Odds Ratio (OR) = 1.71, 95 CI: 1.55-1.88; P < 0.001). Egger's test indicated no publication bias (p = 0.204), but Begg's test did (p = 0.042). By employing the trim and fill method, the revised OR was estimated to be 1.54 (95 CI: 1.40-1.70; P < 0.001). The OR were 2.37 (95 CI: 1.72-3.28; P < 0.001) in cross-sectional studies, 1.72 (95 CI: 1.49-2.00; P < 0.001) in case-control studies, and 1.53 (95 CI: 1.34-1.74; P < 0.001) in cohort studies. Meta-regression showed study design and study region significantly influenced heterogeneity (P < 0.10). Sensitivity and subgroup analyses confirmed the robustness of these findings. Conclusion This systematic review and meta-analysis demonstrate a significant association between maternal tobacco smoking during pregnancy and increased odds of ADHD in offspring. These findings highlight the need for prenatal care guidelines and tobacco smoking cessation programs for pregnant women to reduce ADHD risk and promote optimal neurodevelopmental outcomes. Future research should explore underlying mechanisms and potential confounders further