Spiritual Health, Anxiety and Fear of Childbirth in Iran: Is there Any Relationship?

The most common reason for mothers' request for a cesarean section is fear of childbirth. The present study was conducted to determine the relationship between spiritual health and anxiety and fear of childbirth in pregnant women. This correlational cross-sectional study was performed on 426 pregnant women who were referred to Yahyanejad Hospital in Babol, Iran, during 2018-2021. These pregnant women were hospitalized in the maternity ward for vaginal delivery. Convenience sampling bases on inclusion criteria were done to select the subjects. The questionnaires used in this study included Demographic and Obstetric Questionnaire, Anxiety and Fear of Childbirth Questionnaire by Pirdel et al., and Palutzian & Ellison Spiritual Well-being Scale. Data were analyzed using SPSS version 16 using descriptive and analytical indicators and linear and multiple correlation tests. The results of the study showed that all pregnant women experienced moderate (23.1) or severe (76.9) fear and anxiety, and none of the women had low fear and anxiety. Moreover, all women in this study had moderate (50.5) or high (49.5) spiritual health. The results of linear regression test showed that there is a significant and inverse relationship between spiritual health and anxiety and fear of childbirth (R: - 0.12, CI - 0.14, - 0.019, P = 0.011). Furthermore, the results of multivariate linear regression test after adjustments for intervening demographic and midwifery variables showed a significant relationship between spiritual health (R: - 0.12, CI - 0.14, - 0.02, P = 0.009), education level and number of pregnancies, and anxiety and fear of childbirth. The results of the study showed that with the increase in spiritual health, anxiety and fear of childbirth decreases. Therefore, it can be inferred that women need spiritual care in addition to medical care to deal with fear and anxiety during pregnancy and childbirth.

The Relationship Between Tumor Budding and Patient's Survival in Breast Cancer.

Introduction: Breast cancer is a severe life-threatening condition in which many women are involved yearly. One factor that has recently been noticed and investigated as a diagnostic predictor of this type of cancer is the number of tumor buds and the relation of this factor with a patient's survival rate. Materials and methods: This study includes 150 female patients over 18 years old with a mean age of 53.99 ± 12.56 years old with breast cancer, which was diagnosed at various medical centers, including Rouhani Hospital itself, and referred to Rouhani Hospital Medical Center, Babol, Iran. The number of intratumoral and peritumoral buds in patients' microscopic slides were archived and evaluated along with tumor microenvironment on hematoxylin and eosin (H&E) slides and compared to other clinicopathological findings. This article precisely investigated the relationship between the number of intratumoral and peritumoral buds with patients' 5-year survival rate. Also, the relationship between age, tumor stage, grade, size, the number of lymph nodes involved, and the presence of metastasis with the number of intratumoral and peritumoral buds was studied. Results and discussion: The result showed a significant statistical association between the number of intratumoral and peritumoral buds with tumor size, tumor stage, presence of metastasis, the number of lymph nodes involved, and 5-year survival rate. On the other hand, there is not a significant statistical association between the number of intratumoral and peritumoral buds with age and tumor grade. Conclusion: Our investigation revealed a significant statistical relationship between the number of tumor buds and patients' survival rate. So, this factor should be considered significant to help those patients increase their survival ratio.

Predictive value of body mass index (BMI) and determination of optimum cut-off point in the diagnosis of endometrial hyperplasia in pre-menopausal women with abnormal uterine bleeding.

Background: The suitable BMI cut-off point in persons with endometrial cancer or hyperplasia with abnormal uterine bleeding was investigated in this study. Methods: This case-control research was conducted on 1470 women with abnormal uterine bleeding in Ayatollah Rouhani Hospital,Babol between 2010 and 2012, with 312 participants included in the study. In terms of uterine biopsy results, patients were split into six groups: simple hyperplasia without atypia, simple hyperplasia with atypia, complicated hyperplasia with atypia, complex hyperplasia without atypia, endometrial cancer, and normal persons. Results: The mean age and BMI of patients in these three groups were not significantly different (P equal to 0.081 and 0.435, respectively). The kind of disease exhibited a strong relationship with menstruation (P 0.001). The body mass index (BMI) values ​​did not have significant levels under the curve to determine the appropriate cut-off point in the diagnosis of hyperplasia plus endometrial cancer and endometrial cancer alone (P 0.380 and 0.124, respectively) and hyperplasia alone (P = 0.920). Based on logistic regression, age 50 years and older and irregular menstruation were significant with OR equal to 2.36 and 2.09 (P = 0.011) and HTN with OR equal to 0.44 (P = 0.026), respectively. Conclusion: BMI has little predictive value in the detection of endometrial cancer or hyperplasia, according to the findings, and other diagnostic and screening modalities should be utilized instead. The findings backed up the theory that old age and irregular menstruation are linked to an increased risk of endometrial cancer.

CDX1/2 and KLF5 Expression and Epigenetic Modulation of Sonic Hedgehog Signaling in Gastric Adenocarcinoma.

Gastric cancer is among the commonplace causes of cancer death worldwide. Sonic hedgehog (Shh) signaling is an important pathway which may be dysregulated in many cancers.CDX1/2, and KLF5are key transcription factors involved in Shh pathway and cancer stem cells. The aim of this study was to investigate the expression and epigenetic alterations of these genes in gastric cancer patients. DNA methylation's modifications of CDX1, KLF5 and CDX2 genes alongside with the expressions of these genes in gastric cancer tissues and their non-tumoral counterparts (margin tissues) were analyzed using methylation specific sequencing, and Real time PCR Taq man assays, respectively. The expression of CDX1 (P = 0.002) and KLF5 (P = 0.010) were decreased significantly, but it was considerably increased for CDX2 (P = 0.001). Relatively, the results for the regulatory region methylation status of each CpG site had shown a notable fluctuation in these genes with no significant difference in most places. The creation of metastatic lymph nodes in patients was significantly associated with increased expression of CDX2 gene. The modifications of these genes expression can be considered as a cancer biomarker in future studies. Methylation of the investigated genes is not the main mechanism of gastric cancer development.

Evaluation of oxidative stress in endometriosis: A case-control study.

BACKGROUND: Recent studies have suggested that oxidative stress (OS) may have a contribution in the pathogenesis of endometriosis. However, the results of previous studies regarding OS in endometriosis are controversial. The objective of this study was to compare the serum levels of OS markers in endometriosis versus the control group. METHODS: This case-control study was carried out on 30 women with endometriosis aged 20-38 years presented to Fatemeh Zahra Infertility and Reproductive Health Research Center, Babol, Iran between March 2011 through November 2013. The serum samples of 40 women with same age were collected as the control group. The serum levels of malondialdehyde (MDA), carbonyl and iron were measured by photometric methods and compared between the patient and control groups using t-test. Also, we used ROC curve analysis to determine the discrimination ability of these markers. RESULTS: Serum iron in endometriosis patients was significantly higher than control (p<0.0001). Area under the ROC curve (AUC) for iron, MDA and carbonyl were 0.899, 0.648 and 0.530, respectively. Serum iron at cutoff value of 173.3 µg/dl exhibited high discrimination ability to discriminate endometriosis from control. CONCLUSION: These findings indicate that the high level of serum iron may promote OS in patients with endometriosis. In addition, serum Iron at cut off level of 173.3 exhibits high discriminative ability to distinguish patients with endometriosis from healthy subjects.

Comparison of the analgesic effect of intravenous paracetamol/midazolam and fentanyl in preparation of patients for colonoscopy: A double blind randomized clinical trial.

BACKGROUND: Although some patients can tolerate colonoscopy procedure using fentanyl/ midazolam without any sedation and analgesic requirements but some patients may require additional sedation with benzodiazepines. We performed the present study to compare the effect of paracetamol/midazolam with fentanyl/ midazolam. METHODS: In a clinical trial, 96 patients aged 18 to 75 years old, who were candidate for elective colonoscopy assigned consecutively into two groups as paracetamol/midazolam and fentanyl/midazolam. The first group received 1 gr paracetamol 45 minutes before colonoscopy and 0.5 mg/kg midazolam 5 minutes before colonoscopy whereas the second group received 04- 0.5-1 mcg/kg fentanyl 3 minutes before colonoscopy and similar dose of midazolam. The two groups were compared in regard to patient intensity, discomfort, acolonoscopist and, patient satisfaction and rescue dose of propofol during colonoscopy and vital signs. RESULTS: There was no significant difference between the two groups for patient pain score, colonoscopist satisfaction, patient satisfaction and rescue dose of propofol (P=0.817, 0.978, 0.460, and 0.104, respectively). The incidence of apnea was greater in fentanyl group (P=0.045). After adjusting for age and education, there was also no significant difference between the two groups. CONCLUSION: This study indicates that paracetamol can be considered as an alternative drug regimen in preparation of colonoscopy.

Comparison of maternal and neonatal serum leptin levels in preeclampsia and normal pregnancy.

BACKGROUND: Leptin is a protein product of obesity gene and is synthesized mainly by adipose tissue. OBJECTIVE: The aim of this study was to determine maternal and neonatal serum leptin levels in term preeclamptic and normal pregnancies. MATERIALS AND METHODS: This cross sectional study was performed on 37 preeclamptic and 40 normotensive term pregnant women without other disease. Serum level of leptin was measured in all of pregnant mothers and after delivery, their neonates. This study was performed in Babol Yahyanejad Hospital from March 2006 to December 2006. RESULTS: Infants with preeclamptic mothers had significantly lower leptin level than control group (p=0.02). There was no significant difference in serum leptin levels between normal and preeclamptic women (p=0.749). CONCLUSION: According to the results, it would be concluded that leptin level in infants of preeclamptic mothers is lower than infants of normal mothers. This can only confirm the diagnosis of disease after birth but it cannot predict the preeclampsia.

Association between Local External Gamma Rays and Frequency of Cancer in Babol-Iran.

INTRODUCTION: The effect of natural background radiation on Cancer is still challenging. The investigation of association between external gamma rays and Cancer was the main goal of study. MATERIALS #ENTITYSTARTX00026; METHODS: External Gamma rays were measured using a radiation survey meter in 184 urban and rural health centers to estimate the exposure to the population in residential areas of Babol. The dose distribution map was compared to the 5 years radiation induced cancer incidence data from cancer registry center in north part of Iran. RESULTS: Results showed that although the external gamma ray level in Babol is nearly equal to the average natural background radiation in the world, there is a relatively weak inverse association between local external gamma ray and incidence of Cancer [Correlation coefficient = -0.43, (p<0.01)]. CONCLUSION: This finding might be due to the inhibition of cancer induction following exposure to the low doses of ionizing radiation and probably can be a confirmation of radiation hormesis. However, due to some uncertainties, the conclusion should be interpreted with caution. Further national and international studies are suggested.

The effect of topical application of human milk, ethyl alcohol 96%, and silver sulfadiazine on umbilical cord separation time in newborn infants.

BACKGROUND: Several agents have been used for neonatal umbilical cord care, but we did not find any study evaluating the effect of human milk on umbilical cord separation time. The purpose of this study was to compare the effect of topical application of human milk, ethyl alcohol 96%, and silver sulfadiazine on umbilical cord separation time in newborn infants. This study was undertaken place at a primary-level newborn nursery at a university teaching hospital and a private hospital. Of 373 singleton near- to full-term newborns enrolled in the study, 312 completed the study. METHODS: Newborns from birth were randomized to either: 1) mother's milk group, 2) alcohol group, 3) silver sulfadiazine group, and 4) control (no treatment) group. Mother's milk for group 1, ethyl alcohol for group 2, and silver sulfadiazine ointment for group 3 were applied to the umbilical stump three hours after birth and continued every eight hours until two days after umbilical cord separation. The time to umbilical cord separation and any discomfort such as infection, hemorrhage, and granuloma formation were reported by mothers. Nothing was applied to the umbilical stump of the control group and they received dry cord care only. RESULTS: It was observed a significant difference in the mean cord separation time among the four group. No significant complications were observed in any group. CONCLUSION: Breast milk could be substituted for other topical agents for umbilical cord care, but a multicenter study is required in order to advise it for routine umbilical cord care.