Assessment of the Performances of Adaptive Neuro-Fuzzy Inference System and Two Statistical Methods for Diagnosing Coronary Artery Disease.

Background: The accurate diagnosis of cardiac disease is vital in managing patients' health. Data mining and machine learning techniques play an important role in the diagnosis of heart disease. We aimed to examine the diagnostic performances of an adaptive neuro-fuzzy inference system (ANFIS) for predicting coronary artery disease and compare this with two statistical methods: flexible discriminant analysis (FDA) and logistic regression (LR). Methods: The data of this study is the result of descriptive-analytical research from the study of Mashhad. We used ANFIS, LR, and FDA to predict coronary artery disease. A total of 7385 subjects were recruited as part of the Mashhad Stroke and Heart Atherosclerotic Disorders (MASHAD) cohort study. The data set contained demographic, serum biochemical parameters, anthropometric, and many other variables. To evaluate the ability of trained ANFIS, LR, and FDA models to diagnose coronary artery disease, we used the Hold-Out method.For analyzing data, we used SPSS v25, R 4.0.4, and MATLAB 2018 software. Results: The accuracy, sensitivity, specificity, Mean squared error (MSE) , and area under the roc curve (AUC) for ANFIS were 83.4%, 80%, 86%, 0.166 and 83.4%. The corresponding values based on the LR method were 72.4%, 74%, 70% , 0.175 and 81.5% and for the FDA method, these measurements were 77.7%, 74%, 81%, 0.223, and 77.6%, respectively. Conclusion: There was a significant difference between the accuracy of these three methods. The present findings showed that ANFIS was the most accurate method for diagnosing coronary artery disease compared with LR and FDA methods. Thus, it could be a helpful tool to aid medical decision-making for the diagnosis of coronary artery disease.

The preferences and expectations of married women receiving preconception care in Iran: a qualitative study.

Preconception care (PCC), as an essential strategy in continuity of the care approach for women, could reduce maternal and child mortality. Women's expectations from healthcare providers regarding PCC are different based on their knowledge, experiences and culture. The purpose of this study was to explore Iranian women's preferences and expectations regarding PCC. In this qualitative content analysis 22 married women with intention to become pregnant were recruited from 22 healthcare centers in Mashhad, Iran, using purposive sampling. Data were collected through semi-structured in-depth interviews from March to October 2014. Interviews were transcribed verbatim and analyzed using a conventional content analysis approach. The main expectation of women regarding PCC was "being supported and receiving continuing care". This overarching theme consisted of five categories including continuity of care, couple-centered care, establishing effective communication, accessibility to preconception services and access to competent professionals. Women highlighted their expectations as the need of support and to receive continuing healthcare. They requested PCC for couples and emphasized the importance of the health professional's competency as well as access to information and services of PCC. Women's experiences manifested several areas within which changes could be applied to improve the quality of preconception care.

Genetic and epigenetic factors influencing vitamin D status.

The global prevalence of vitamin D deficiency appears to be increasing, and the impact of this on human health is important because of the association of vitamin D insufficiency with increased risk of osteoporosis, cardiovascular disease and some cancers. There are few studies on the genetic factors that can influence vitamin D levels. In particular, the data from twin and family-based studies have reported that circulating vitamin D concentrations are partially determined by genetic factors. Moreover, it has been shown that genetic variants (e.g., mutation) and alteration (e.g., deletion, amplification, inversion) in genes involved in the metabolism, catabolism, transport, or binding of vitamin D to it receptor, might affect vitamin D level. However, the underlying genetic determinants of plasma 25-hydroxyvitamin D3 [25(OH)D] concentrations remain to be elucidated. Furthermore, the association between epigenetic modifications such as DNA methylation and vitamin D level has now been reported in several studies. The aim of current review was to provide an overview of the possible value of loci associated to vitamin D metabolism, catabolism, and transport as well epigenetic modification and environmental factors influencing vitamin D status.

High dose vitamin D supplementation can improve menstrual problems, dysmenorrhea, and premenstrual syndrome in adolescents.

Vitamin D has a crucial role in female reproduction, possibly through its effects on calcium homeostasis, cyclic sex steroid hormone fluctuations, or neurotransmitter function. We have assessed the effects of vitamin D supplementation on dysmenorrhea and premenstrual syndrome (PMS) in adolescents. In this study, 897 adolescent girls living in Mashhad and Sabzevar, Iran, received nine high-dose vitamin D supplements (as 50,000 IU/week of cholecalciferol) and were followed up over 9 weeks. We evaluated the effect of vitamin D supplementation on individuals in four categories: those with only PMS; individuals with only dysmenorrhea; subjects with both PMS and dysmenorrhea and normal subjects. The prevalence of PMS after the intervention fell from 14.9% to 4.8% (p < .001). Similar results were also found for the prevalence of subjects with dysmenorrhea (35.9% reduced to 32.4%), and in subjects with both PMS and dysmenorrhea (32.7% reduced 25.7%). Vitamin D supplementation was associated with a reduction in the incidence of several symptoms of PMS such as backache and tendency to cry easily as well as decrement in pain severity of dysmenorrhea (p < .05). High dose vitamin D supplementation can reduce the prevalence of PMS and dysmenorrhea as well as has positive effects on the physical and psychological symptoms of PMS.

Prevalence of combined and noncombined dyslipidemia in an Iranian population.

BACKGROUND: Combination of dyslipidemic phenotypes, including elevated plasma levels of low-density lipoprotein cholesterol (LDL-C), elevated plasma triglycerides (TG), and decreased low-density lipoprotein cholesterol (HDL-C) concentrations, is important because of the association of individual phenotypes with increased risk of cardiovascular disease (CVD). We investigated the prevalence of combined dyslipidemias and their effects on CVD risk in an Iranian large population. METHOD: A total of 9847 individuals were recruited as part of the Mashhad Stroke and Heart Atherosclerotic Disorders (MASHAD) cohort study. Anthropometric parameters and biochemical indices were measured in all of the subjects. Different types of combined dyslipidemias including high TG + low HDL-C, high TG + low HDL-C + high LDL-C, low HDL-C + high LDL-C, high TG + high LDL-C, and finally high TG + high LDL-C + low HDL-C were considered. Ten-year CVD risk was calculated using the QRISK2 risk algorithm and adjustments were made as suggested by the Joint British Societies' (JBS2). Logistic regression analyses were performed to determine the association between different combined dyslipidemias and categorical QRISK. RESULTS: A total of 3952 males and 5895 females were included in this current study. Among the included subjects, 83.4% had one form of dyslipidemia, and 16.6% subjects were not dyslipidemic. The mean age was 48.88 ± 7.9 and 47.02 ± 8.54 years for dyslipidemic and nondyslipidemic groups, respectively. The results showed that the frequency of dyslipidemia was 98%, 87.1%, and 90% in subjects with metabolic syndrome, CVD, and diabetes, respectively. Our results suggested that around 15.7% of study population were at 10 years CVD risk (high ≥20) and it was higher in men than women (P < .001). Moreover, risk of CVD was higher in TG↑ & HDL↓ & LDL↑ group than other groups. CONCLUSION: Prevalence of dyslipidemia was 83.4% among Iranian adults. The results showed that individuals with increased plasma TG and LDL-C, and low HDL-C levels had the highest 10 years CVD risk compared to other combined dyslipidemic phenotypes.

Menstrual disorders and premenstrual symptoms in adolescents: prevalence and relationship to serum calcium and vitamin D concentrations.

There have been several studies evaluating the association between vitamin and mineral status and menstrual disturbance. In the present study, we aimed to assess the relationship between the menstrual bleeding pattern and premenstrual syndrome (PMS) symptoms with serum 25-hydroxyvitamin D, and calcium levels in adolescent girls. A cross-sectional study was carried out in 897 high school girls from northeastern Iran. The prevalence of hypocalcaemia, normal serum calcium and hypercalcaemia was 27.1, 59.8 and 13.1%, respectively. The menstrual flow of participants differed significantly between the calcium status groups (p = .005). There was no significant association between the symptoms of PMS, as assessed by the questionnaire and serum vitamin D status, or serum calcium concentrations, apart from the irritability. There appears to be an association between serum calcium, menstrual blood loss and irritability in adolescent girls. Impact statement What is already known on this subject? Several studies have evaluated the association of vitamin and mineral status with menstrual disturbance, although these relationships are not consistent, specifically among calcium and vitamin D levels with a menstrual bleeding pattern. What do the results of this study add? In the present study, we investigated the correlation of menstrual bleeding patterns and PMS with calcium and vitamin D levels in a large population in adolescent girls. We found that the level of calcium was associated with the level of menstrual blood loss and irritability. However, no significant association was observed between the menstrual bleeding pattern or the PMS symptoms with a vitamin D status. What are the implications of these findings for future clinical practise/research? Further studies are required to assess the value of a calcium adequate intake or a calcium supplementation for the amelioration of PMS and a better understanding the role of calcium in PMS.

High Dose Supplementation of Vitamin D Affects Measures of Systemic Inflammation: Reductions in High Sensitivity C-Reactive Protein Level and Neutrophil to Lymphocyte Ratio (NLR) Distribution.

The prevalence of Vitamin D deficiency is increasing worldwide, which has be shown to be associated with increased risk of cardiovascular disease (CVD), autoimmune disease, and metabolic syndrome. These conditions are also associated with a heightened state of inflammation. The aim of the current study was to evaluate the effect of vitamin D supplementation on serum C-Reactive Protein (CRP) level and Neutrophil-to-lymphocyte ratio (NLR) distribution in a large cohort of adolescent girls. A total of 580 adolescent girls were recruited follow by evaluation of CRP and hematological parameters before and after supplementation with vitamin D supplements as 9 of 50000 IU cholecalciferol capsules for 9 weeks taken at weekly intervals. At baseline, serum hs-CRP level was 0.9 (95%CI: 0.5-1.8), while this value after intervention was reduced to 0.8 (95%CI: 0.3-1.6; P = 0.007). Similar results were also detected for NLR (e.g., NLR level was 1.66 ± 0.72 and 1.53 ± 0.67, P = 0.002, before and after therapy with compliance rate of >95.2%). Moreover, we found an association between hs-CRP and BMI, triglyceride, white blood cell count, and lymphocytes. Interestingly we observed a significant reduction in neutrophil count and CRP level after high dose vitamin D supplementation. Our findings showed that the high dose supplementation of vitamin D affects measures of systemic inflammation: reductions in High Sensitivity C-Reactive Protein level and Neutrophil-to-lymphocyte ratio (NLR) distribution. J. Cell. Biochem. 118: 4317-4322, 2017. © 2017 Wiley Periodicals, Inc.

Association of hematocrit with blood pressure and hypertension.

BACKGROUND: Hypertension (HTN) is a risk factor for stroke, renal failure, and cardiovascular disease. The association between biochemical and hematological parameters with high blood pressure may provide a more precise approach to risk prediction conferred by HTN in these patients. OBJECTIVE: The aim of current study was to explore whether biochemical and hematological parameters are associated with HTN in a cohort study with a 7-year follow-up. MATERIALS AND METHODS: A total of 9808 individuals were enrolled and recruited as part of the Mashhad Stroke and Heart Atherosclerotic Disorders (MASHAD) cohort study, and biochemical and hematological factors were measured in all subjects. Univariate and multivariate logistic regression analysis were performed to determine the association of biochemical and hematological parameters with HTN. RESULTS: Several biochemical parameters including fasting plasma glucose (FBG), serum high-sensitivity C-reactive protein (hs-CRP), triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and uric acid were increased in hypertensive participants. In contrast, serum high-density lipoprotein cholesterol (HDL-C) was lower in hypertensive individuals. Furthermore, we demonstrated that hematological parameters including white blood cell (WBC) count, red blood cell (RBC) count, hemoglobin (HGB), hematocrit (HCT), and mean corpuscular hemoglobin (MCH) were higher in the hypertensive group compared to the control group. But mean corpuscular volume (MCV), and red cell distribution width (RDW), were decreased in the hypertensive group. Furthermore, our results strongly suggested that among these parameters, hematocrit was the independent risk factor for hypertension in the population. CONCLUSION: We demonstrated the association of altered biochemical and hematological factors with hypertension supporting the value of emerging markers for early prediction of high blood pressure in prone individuals.

The Effects of Curcumin and Curcumin-Phospholipid Complex on the Serum Pro-oxidant-Antioxidant Balance in Subjects with Metabolic Syndrome.

Metabolic syndrome (MetS) is defined by a clustering of metabolic and anthropometric abnormalities and is associated by an increased risk of cardiovascular disease. We have investigated the effect of curcumin supplementation on the serum pro-oxidant-antioxidant balance (PAB) in patients with MetS. This double-blind, randomized, placebo-controlled trial was conducted over 6 weeks. Subjects (n = 120) were randomly allocated to one of three groups (curcumin, phospholipidated curcumin, and placebo). The curcumin group received 1 g/day of simple curcumin, the phospholipidated curcumin group received 1 g/day of phospholipidated curcumin (containing 200 mg of pure curcumin), and the control group received 1 g/day of placebo. Serum PAB was measured before and after the intervention (at baseline and at 6 weeks). Data analyses were performed using spss software (version 16.0). Serum PAB increased significantly in the curcumin group (p < 0.001), but in the phospholipidated curcumin group, elevation of PAB level was not significant (p = 0.053). The results of our study did not suggest any improvement of PAB following supplementation with curcumin in MetS subjects. Copyright © 2017 John Wiley & Sons, Ltd.

Interleukin 18 (-137G/C, -607C/A) Polymorphisms as Genetic Biomarkers of Susceptibility to Systematic Lupus Erythematosus.

BACKGROUND: Systemic lupus erythematosus (SLE) is an autoimmune disease of unknown etiology. Several studies have suggested that interleukin-18 (IL-18) is associated with SLE pathogenesis. The genotype distribution of IL-18 promoter polymorphisms differs among ethnic populations. The present study aimed to investigate the correlation between IL-18 polymorphisms at positions -137 and -607 in patients situated in Northeastern Iran. METHODS: This case-control study examined the prevalence of IL-18 -137C/G and -607C/A polymorphic variants among 95 SLE patients referred to the Department of Rheumatology, who were referred to the general clinics of Ghaem Hospital and Imam Reza Hospital in Mashhad, Iran, were included in the study. In addition, 100 healthy individuals were included in the control group. DNA from whole blood was extracted by the salting-out method using a commercial kit (Biogene, US). Allelic and genotypic frequencies of polymorphisms (-137G/C, -607C/A) in the IL-18 promoter gene were analyzed using a polymerase chain reaction (PCR)-based amplification refractory mutation system (ARMS) method. RESULTS: The results of this study demonstrated that the frequency of SLE patients with the homozygous C/C genotype of the IL-18 promoter gene at position -137 was significantly higher than that of the homozygous G/G genotype (P < 0.001) in normal controls. Furthermore, the polymorphism analysis performed illustrated a significant association between (-137G/C) and (-607C/A) polymorphisms in the IL-18 promoter gene and SLE (P < 0.005). CONCLUSION: These results indicated that the 607A/A and 137C/C polymorphisms are more prevalent in SLE. Further research involving larger sample sizes from various populations is necessary to elucidate the role of these polymorphisms and the distribution of alleles in SLE patients.

Investigation of the relationship between atherogenic index, anthropometric characteristics, and 10-year risk of metabolic syndrome: a population-based study.

BACKGROUND: People with metabolic syndrome (MetS) are at a higher risk of coronary artery disease, diabetes mellitus, stroke, osteoarthritis, and some types of cancers. Finding markers which are available and inexpensive are most useful for the prediction of MetS. The present study aimed to determine the relationship between atherogenic index and anthropometric indicators and the 10-year risk of MetS. METHODS: During the 10-year follow-up on Mashhad stroke and heart atherosclerotic disorder (MASHAD study), 4684 subjects who did not MetS at baseline were recruited in this study. The anthropometric indices and atherogenic index including atherogenic index of plasma (AIP), Castelli's risk index I and II (CRI-I, CRI-I), and atherogenic coefficient (AC) were measured. SPSS-23 was used for all statistical analyses. RESULT: Among subjects who did not have MetS at baseline 1599 cases (34.1%) developed MetS. The anthropometric and lipid indices were significantly elevated in patients with MetS compared to the healthy ones (p < 0.001). It was revealed that an increase of one unit in AIP and AC can raise the risk of MetS 22.7% (OR: 1.227 (95% CI, 1.166-1.291)) and 37.7% (OR: 1.377 (95% CI, 1.291-1.468)), respectively. Moreover, increasing one unit of WHtR decreases the risk of MetS by 8.5% (OR: 0.915 (95% CI, 0.886-0.946)). CONCLUSION: The results of this longitudinal study showed that increasing AC and AIP could enhance the risk of MetS. The present study also indicated that AC and AIP are useful predictors in the clinical setting for identifying individuals with MetS in the Iranian adult population.

Female or Male Fertility Motivation? Which One Determines the Number of Children? (A Comparative Study).

Background: In the last three decades, childbearing in Iran has decreased more than many countries in the world. The aim of this study was to explore the fertility motivation of Working women and their husbands and discover which one determines the number of children. Materials and Methods: This correlational study was conducted on 540 employed, married women and their husbands (270 couples) living in Mashhad, Iran, during 2017-2018. The participants were selected through multistage cluster sampling. Then, a random number table was used. Subsequently, questionnaires were distributed and completed at home, and collected after 24 h. Data were collected using a demographic characteristics form and the Childbearing Questionnaire (CBQ). Results: The mean(SD) positive motivation scores of men and women differed significantly [92.77 (13.04) Vs. 92.22 (13.51) df = 4; p = 0.001;]. The mean (SD) negative motivation scores of men and women also differed significantly 55.42 (10.94) Vs. 56.78 (10.57) df = 4; p = 0.001;]. Conclusions: According to the scores obtained for the positive and negative fertility motivations of working women and their husbands, women were more in favor of having children and had an ambivalent motivation to bear children. Moreover, the working women's spouses were more indifferent to fertility. The results of this study can help reproductive health policymakers in childbearing.

Positive Consequences of the Hidden Curriculum in Undergraduate Nursing Education: An Integrative Review.

Background: Hidden Curriculum (HC) plays an essential role in nursing education and professionalism. However, its positive consequences have been overlooked. Thus, this study aimed to explore and discuss the positive consequences of HC in nursing undergraduate education. Materials and Methods: A comprehensive literature search was conducted to investigate articles published between January 2010 and December 2020. Furthermore, Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used to select articles, and Consolidated criteria for Reporting Qualitative research (COREQ) and Strengthening the Reporting of Observational studies in Epidemiology (STROBE) tools were employed to appraise qualitative and quantitative studies, respectively. The applied search strategy resulted in a final list of 16 articles out of a total of 132 articles. Next, the data were integrated and categorized using the Whittemore and Knafl methodology. Results: Three categories were identified: Individual Consequences; involving increased self-confidence, self-esteem, assertiveness, adaptation, autonomy, and lifelong learning. Social Consequences; involving enhanced socialization, cultural consciousness, and social interactions. Professional Consequences; involving professional socialization, professional identity, professional ethics, link theory and practice, and professional dignity. Conclusions: Altogether, we concluded that the emergence of HC and its positive and remarkable consequences in nursing knowledge helps the personal, social, and professional development in nursing.

Altered triglyceride glucose index and fasted serum triglyceride high-density lipoprotein cholesterol ratio predict incidence of cardiovascular disease in the Mashhad cohort study.

The triglyceride glucose (TyG) index and triglyceride/high lipoprotein density cholesterol (TG/HDL-C) are two important risk markers to evaluate the insulin resistance and cardiovascular diseases (CVDs). To assess the association between TG/HDL-C and TyG index and CVDs. The Mashhad stroke and heart association disorder cohort study started in 2010 and has been continued until 2020. During 6-year follow-up of 9704 participants, 235 events including 118 acute coronary syndrome (ACS), 83 chronic coronary syndrome, 27 myocardial infarction, and 27 cardiac death were confirmed. SPSS software (version 21) was used for statistical analysis and figures were drawn by GraphPad Prism 6 software. The prevalence of ACS and cardiac death were higher in the fourth quartile of serum TG/HDL-C (>4.43) and higher prevalence of ACS was considered in subjects classified in the fourth quartile of TyG index (>8.98). A high TyG index was associated with an increased risk of ACS and cardiac death [1.362 (95% confidence interval [CI]: [1.013-1.831]) and 2.3 (95% CI: [1.247-4.241])] respectively; based on Cox regression analysis elevated TyG and TG/HDL-C increased the chance of CVD by [1.634 (95% CI: 1.304-2.047) and 1.068 (95% CI: 1.031-1.105)], respectively. Our results strongly showed that TyG index and TG/HDL-C are independent risk factors for incident CVD, suggesting that TyG index and TG/HDL-C may be as an important unique biomarker for predicting CVD outcomes and progression.

Association of a genetic variant in Interleukin-10 gene with increased risk and inflammation associated with cervical cancer.

BACKGROUND: Cervical-cancer is among the most commonly diagnosed cancers in women, and infection with human papillomavirus (HPV) is associated with an increased risk of cervical cancer and altered serum concentrations of inflammatory cytokines. We have explored the association between a genetic variation in the Interleukin-10 (IL-10) gene (rs1800896) and cervical cancer risk and its relationship with tissue Interferon gamma (IFN-γ), Transforming growth factor beta (TGF-ß), Tumor necrosis factor alpha (TNF-α) concentrations in women with cervical cancer. METHODS: A total of 315 women with, or without cervical cancer, were recruited into the study. DNA was extracted from cervical cells, and genotyping was undertaken using Taq-man real-time PCR. The genotype frequency and allele distribution were analyzed together with their association with pathological data. The association of the rs1800896 gene variation with tissue levels of the inflammatory cytokines was also investigated. RESULTS: Our data showed a significant association between the A allele of the rs1800896 gene variant and the presence of cervical cancer. In particular, patients with AG/AA genotypes had an increased risk of cervical cancer with an odds ratio of 1.929 (95% confidence interval [CI]: 0.879-4.23, P < 0.001) in a recessive model, compared with the GG genotype. Also, the tissue concentrations of IFN-γ, TGF-ß, and TNF-α in cervical tissues were significantly higher in women with cervical cancer (P < 0.001) and were associated with the AA genotype. CONCLUSION: We have found an association between the polymorphism rs1800896 in the IL-10 gene and an increased risk of cervical cancer as well as a higher level of tissue inflammatory cytokines. Further investigations are necessary on the value of emerging biomarkers for the risk stratification for the management of cervical cancer patients.

Association of the colorectal cancer and MDR1 gene polymorphism in an Iranian population.

The human multidrug resistance (MDR1) gene product P-glycoprotein is highly expressed in intestinal epithelial cells, where it constitutes a barrier against xenobiotics, bacterial toxins, drugs and other biologically active compounds, possibly carcinogens. In this study, an association of MDR1 gene polymorphism and the occurrence of colorectal cancer were evaluated. In this case-control-designed 118 unrelated colorectal cancer and 137 sex-and-ages matched healthy controls were enrolled. The C3435T MDR1 gene polymorphism was identified using the polymerase chain reaction-restriction fragment length polymorphism method. Significantly increased frequencies of the 3435T allele and the 3435TT were observed in patients with colorectal cancer compared with controls (P = 0.03; OR, 95% CI; 1.46 for 3435T allele and P = 0.003; OR, 95% CI; 2.2 for 3435TT genotype). In contrast, frequency of genotype TT was significantly higher in controls compared to colorectal cancer (P = 0.006; OR, 95% CI; 0.49 for TC genotype). In this study suggest that C3435T MDR1 polymorphism has an association with colorectal cancer. The results support that the presence of allele C results in decreased susceptibility to colorectal cancer.

Evaluation of visual inspection with acetic acid as a feasible screening test for cervical neoplasia.

AIM: Alternative methods for cervical cancer screening have been sought. One method, direct visualization with acetic acid (VIA), has proven itself in many clinical trials as an adequate alternative to Pap-smears in developing countries. This study was designed to assess if visual inspection with acetic acid (VIA test) could be an appropriate alternative method for cervical cancer screening. Therefore, we compared VIA, as a stand-alone test, with the gold standard test (colposcopy) in detecting significant cervical pathology in our setting. MATERIALS AND METHODS: The study population consisted of the women who attended the Gynecological Clinic in Ghaem Hospital from April 2008 to April 2009. All of them were tested with VIA. Then, 100 test-positive women and 100 test-negative women were randomly selected and underwent cytology and colposcopy. Cervical biopsies were conducted for the women with abnormal colposcopic findings. Sensitivity, specificity, positive predictive value and negative predictive value were calculated for each test and then were compared. RESULTS: Sixty-nine women in the VIA-positive group and 61 women in the VIA-negative group had abnormal cytology. After studying the biopsies, 58 women with positive VIA, and two women with negative VIA had a final diagnosis of dysplasia. Positive predictive value for VIA and cytology were 58% and 33%, respectively. CONCLUSION: The results of this study indicate that VIA may be a useful and feasible alternative screening test for cervical precancerous and cancerous lesions.

The effect of face-to-face and telephone counseling on the desire for adoption in infertile couples.

BACKGROUND: Fertility is always one of the most important functions of the family. Having a child equals growing up and entering the adult world. Adoption is one of the methods that can be considered to treat infertility. One of the duties of health professionals, especially midwives, is to advise and educate infertile people, which helps them in a way beyond medical treatment. Therefore, this study was conducted to determine the effect of face-to-face and telephone counseling on the desire for adoption in infertile couples. MATERIALS AND METHODS: The present study was a two-group counseling intervention study that was performed on 34 infertile couples referred to Mashhad Infertility Center. Infertile couples were randomly assigned to face-to-face and telephone counseling groups. All participants completed the Adoption Adoption Questionnaire at the beginning and end of the study. Data were analyzed by spss16 software. RESULTS: The mean score of propensity to adopt in the face-to-face counseling group 2 weeks after the intervention was significantly higher than before the intervention. Furthermore, the mean score of desire for adoption in the telephone counseling group increased significantly 2 weeks after the intervention compared to before (P < 0.001). Adoption scores varied in the face-to-face counseling group at 3.15 and in the telephone counseling group at 3.23. There was no statistically significant difference between the two groups (P < 0.885). The most common reason for not wanting to adopt was hope for self-treatment and having children (70.6% women and 67.6% men). The most common reason for accepting an adopted child was the strong need to have a child (23.5% in women and 23.5% in men). CONCLUSION: According to the results of this study, counseling can increase people's awareness of the conditions of adoption and thus increase the desire of people to accept the adopted child. For this reason, considering adoption counseling sessions for infertile couples who have been receiving infertility treatment for a long time but have not become pregnant can help the couple decide.

Comparative study of the effect of two counseling methods on fertility motivation in infertile couples.

BACKGROUND: Reproductive motivation is a complex issue that has cultural, behavioral, and ideological roots and changes in the context of population transfer and economic and social development. Reproductive motivations include positive and negative motivations that can be influenced by education. Training can be done in different ways. It seems that face-to-face training increases learning. On the other hand, face-to-face training increases participants' cooperation and desire for educational topics. Therefore, the aim of this study was to compare and determine the effect of two counseling methods on the fertility motivation of infertile couples. MATERIALS AND METHODS: This intervention study was performed on 68 men and women with infertility referring to Milad Infertility Center in Mashhad in 2016-2017. Subjects were randomly assigned to two methods of counseling. Participants completed written consent to participate in the study. Infertile couples were included in the study if they met the inclusion criteria. The fertility motivation questionnaire was completed by the participants at the beginning of the study before the consultation and 2 weeks after the consultation. The collected data were analyzed by SPSS Software Version 16. RESULTS: According to the independent t-test, there was no statistically significant difference between the mean scores of positive fertility motivation in the two groups of face-to-face and telephone counseling before the intervention. Independent t-test showed that 2 weeks after the intervention, there was no significant difference between the two groups in terms of this variable (P = 0.283). There was no statistically significant difference between the mean scores of positive fertility motivation in the face-to-face counseling group before and after the intervention. Further, in the telephone counseling group, there was no significant difference between the mean scores of positive fertility motivation in the two stages before and after the intervention. According to the independent t-test, there was a statistically significant difference between the mean scores of negative fertility motivation in the two groups of face-to-face and telephone counseling before the intervention (P = 0.025). However, this test showed that there was no significant difference between the two groups in terms of this variable 2 weeks after the intervention. CONCLUSION: The results of this study showed that face-to-face and telephone counseling did not have a significant effect on fertility motivations of infertile couples. In other words, the mean scores of positive and negative fertility motivations before and after counseling remained unchanged in both groups and the two groups did not differ in this regard. In other words, the issue of fertility motivation in infertile women can be affected by different characteristics such as social, family, cultural, and economic conditions of individuals. If infertile people do not make having a child a necessity in their lives and cope with it more easily, no counseling can change their motivation. On the other hand, if infertile women consider having a child as an essential part of their married life and the health of their married life, counseling can have the greatest effect on them.

A Novel Splice Site Variant in the LDLRAP1 Gene Causes Familial Hypercholesterolemia

Background: familial hypercholesterolemia (FH), a hereditary disorder, is caused by pathogenic variants in the LDLR, APOB, and PCSK9 genes. This study has assessed genetic variants in a family, clinically diagnosed with FH. Methods: A family was recruited from MASHAD study in Iran with possible FH based on the Simon Broom criteria. The DNA sample of an affected individual (proband) was analyzed using whole exome sequencing, followed by bioinformatics and segregation analyses. Results: A novel splice site variant (c.345-2A>G) was detected in the LDLRAP1 gene, which was segregated in all affected family members. Moreover, HMGCR rs3846662 g.23092A>G was found to be homozygous (G/G) in the proband, probably leading to reduced response to simvastatin and pravastatin. Conclusion: LDLRAP1 c.345-2A>G could alter the phosphotyrosine-binding domain, which acts as an important part of biological pathways related to lipid metabolism.