Impact of environmental tobacco smoke exposure in women on oxidative stress in the antral follicle and assisted reproduction outcomes.

BACKGROUND: Cigarette smoke contains many oxidants and may alter the human reproduction by inducing oxidative stress (OS) in both active and passive smokers. This study was designed to evaluate the effect of environmental tobacco smoke (ETS) exposure on oxidative stress in the follicular fluid and the assisted reproduction outcomes. MATERIALS AND METHODS: An observational prospective study was carried out on 236 infertile women, who underwent assisted reproduction cycles. The ETS exposure was assessed using self-reported ETS exposure and the cotinine level in follicular fluid. To evaluate the OS in follicular fluid (FF) malon-di-aldehyde (MDA) and total antioxidant capacity (TAC) were measured. The number of retrieved oocytes, rate of metaphase II stage oocytes, fertilization rate, good cleavage rate, and no-fragmented embryo rate were considered as the assisted reproduction outcomes. The results were adjusted for age, body mass index, duration, and etiology of infertility; P-values less than 0.05 were considered significant. RESULTS: The MDA and TAC levels in FF were not related to the self-report number of the weekly ETS exposure and cotinine levels in FF. Also, the number of retrieved oocytes, MII stage oocytes, fertilization rate, good cleavage rate, and no-fragmented embryo rate were not related to the cotinine level and weekly ETS exposure. However, in women whose cotinine levels in FF were lower and equal/above 3.5 ng/ml, the number of retrieved oocytes was higher (12.63 ± .71 vs. 9.28 ± 1.11, P = 0.01). The relationship between the MDA level and cleavage rate (Beta = -18.5, confidence interval-34.9 and-2.1, P < 0.05) was negatively significant and the relationship between the MII stage rate with TAC (Beta = 0.02, confidence interval 0.01 and 0.04, P < 0.05) was positively significant. CONCLUSION: The ETS exposure may alter the assisted reproduction success by influencing the number of available oocytes. Although, the OS in a follicular environment affect the ability of oocytes to reach the specific cleavage stages at appropriate time intervals, it does not mediate poor-assisted reproduction outcomes due to ETS exposure.

Prevalence and potential risk factors of female sexual difficulties: an urban Iranian population-based study.

INTRODUCTION: Female sexual dysfunction is common, a multifactorial phenomenon with a potential to cause marital strain, impaired fertility, and poor quality of life. Epidemiologic data are scarce and little is known about the prevalence of sexual difficulties and the exact role of putative risk factors in Iran. AIM: To determine the prevalence of female sexual difficulties and the potential risk factors in an urban Iranian population. METHODS: A cross-sectional study was performed in the province of Kohgilooyeh-Boyerahmad (KB) in the southwest of Iran and involved sexually active urban women aged 15 years and over, selected via a quota-based cluster sampling method. The study used an ad hoc questionnaire covering the demographic and reproductive variables as well as the data related to sexual difficulties. Data were analyzed using multiple logistic regression models. The main outcome measures were the prevalence rates and the predictors of sexual difficulties. MAIN OUTCOME MEASURES: The prevalence of female sexual difficulties and the associated risk factors. RESULTS: One thousand four hundred fifty-six sexually active women living in the urban areas of KB province in 2005 were selected. The mean age of the sample was 34.04 +/- 9.2 (16-71) years and the mean number of completed grades was 7.18 (+/-4.8). More than 52% of the participants had experienced at least one type of sexual difficulty. The greatest and smallest frequencies were observed for orgasm difficulty (21.3%, confidence interval[CI](0.95) = 19.2-23.4%) and lubrication difficulty (11.9%, CI(0.95) = 10.2-13.6%). Age, education, contraceptive modality, and obstetric/gynecologic procedures were all associated with at least one type of sexual dysfunction. CONCLUSION: Similar to previous studies, we found a relatively high prevalence of sexual difficulties in this urban population of low socioeconomic status. However, our results concerning the role of some demographic and reproductive variables in producing sexual difficulties were different from those reported by other researchers.

Association between Carbohydrate Quality Index and general and abdominal obesity in women: a cross-sectional study from Ghana.

OBJECTIVES: The relationships between carbohydrate intake and risk of obesity have been widely investigated. However, there are limited data on the associations between their relative proportions and quality contained in the same diet on risk of obesity, especially in low-income and middle-income countries. The aim of this study was to assess the relationship between an overall Carbohydrate Quality Index (CQI) and general and abdominal obesity in women. SETTING AND PARTICIPANTS: In this cross-sectional study, data from 277 women in Ghana were analysed. Dietary information was obtained from 2-day 24 hours dietary recalls. CQI was calculated from the four indices dietary fibre, Glycaemic Index, whole grains/total grains ratio and solid carbohydrates/total carbohydrates ratio. OUTCOME MEASURES: Body mass index, waist circumference (WC), waist-to-height ratio (WHtR) and Conicity Index were measured. RESULTS: After adjusting for covariates, the chance for general obesity (OR 0.25, 95% CI 0.10 to 0.65) and abdominal obesity measured by WC (OR 0.22, 95% CI 0.08 to 0.58) were significantly lower in the topmost quintile of CQI in comparison with the lowest quintile. In addition, the OR for higher WHtR (OR 0.27, 95% CI 0.11 to 0.69) was significantly lower among participants in the fifth quintile of CQI compared with those in the first quintile. CONCLUSIONS: The present study demonstrates that there is an inverse association between dietary CQI and both general and abdominal obesity. These findings suggest that CQI may be used for the improvement of dietary intake to prevent obesity.

Causes of conflict between clinical and administrative staff in hospitals.

BACKGROUND: Providing the high-quality services in hospitals depends on to minimize conflict between all members within a health team. This study aimed to identify the causes of conflicts experienced by clinical and administrative staff in hospitals. METHODS: A cross-sectional study was carried out in 2018. The sample included 320 clinical and administrative staff from six hospitals affiliated to Ardabil University of Medical Sciences that were selected using two-step clustering sampling method. Data collection was accomplished by self-administered questionnaires. Descriptive statistics, t-test, and ANOVA were used for data analysis. RESULTS: Total conflict score revealed that clinical staff had higher levels of perceived conflict than administrative staff. In terms of organizational position, the study results showed a significant difference in the reported conflict between nurse groups and other groups (physicians and paramedical, administrative, financial, and logistic staff). The most important causes of conflict in the viewpoint of clinical staff were organizational and job characteristics (3.54 ± 1.28), poor management (3.51 ± 1.12), and inefficient communication system (3.42 ± 1.33). For administrative staff, on the other hand, poor management (3.18 ± 1.33), inefficient communication system (3.17 ± 1.36), and attitudes and perceptions (3.06 ± 1.41) were shown to be paramount factors. CONCLUSION: Clinical and administrative staff of hospitals are like parts of a train track. The irrational relationship between them will result in distortion and lower quality of services. Therefore, effective strategies to decrease staffs' experience of conflict need to be developed. This might create a healthier and more productive work environment which positively affects the care quality.

Relationship between Energy Expenditure Related Factors and Oxidative Stress in Follicular Fluid.

BACKGROUND: This study evaluated the impact of body mass index (BMI), total calorie intake and physical activity (PA) as energy expenditure related factors on oxidative stress (OS) in follicular fluid (FF). MATERIALS AND METHODS: This prospective study conducted on 219 infertile women. We evaluated patients' BMI, total calorie intake and PA in their assisted reproduction treatment cycles. Malondialdehyde (MDA) and total antioxidant capacity (TAC) in pooled FF at oocyte retrieval were additionally assessed. RESULTS: There was no relation between OS biomarkers to total calorie intake and PA. The TAC levels in FF adjusted for age, duration of infertility, etiology of infertility, number of used gonadotrophin and PA showed a positive relation to BMI (p=0.001). The number of used gonadotrophin and PA had a negative relation to duration of infertility (p=0.03) and anovulation disorder as an etiology of infertility. The MDA level in FF had a positive association with anovulation disorder as the etiology of infertility (p=0.02). MDA in FF was unaffected by BMI. CONCLUSION: Increasing age, BMI and PA do not affect OS in FF. In women with longtime infertility and those with anovulation disorder as an etiology of infertility, decreased potent antioxidant defense in the follicular microenvironment may contribute to ovarian function. Therefore antioxidant supplements may be beneficial for these groups of women.

Stability of Freeze-Dried Sera Stored at Different Temperatures for the Detection of Anti-Leishmania infantum Antibodies Using Direct Agglutination Test.

BACKGROUND: This study aimed to evaluate freeze-dried sera as an alternative to non-freeze dried for detection of anti-Leishmania infantum antibodies over the course of 11 months using the direct agglutination test (DAT). METHODS: Altogether, 60 serum samples (30 from humans and 30 from dogs) were collected from various geographical locations in Iran. All the collected sera were pooled and each pooled serum sample contained 10 different sera. In the beginning, the human and dog pooled sera were categorized as positive (weak and strong) and negative based on anti-L. infantum antibodies using the DAT. All the freeze-dried and non-freeze-dried sera were stored at -70°C, -20°C, 4°C, 22-28°C and 56°C for 11 months. The positive and negative human and dog pooled sera were separately tested using the DAT each month and the results were compared to non-freeze-dried sera kept under the same conditions. RESULTS: We found strong agreement (100%) between the results obtained from freeze-dried human and dog in strong DAT positive sera kept at -70°C, -20°C, 4°C and 22-28°C during this study. The human and dog pooled sera stored at 56°C were corrupted after 2 weeks. The DAT results were highly reproducible using freeze-dried human pooled sera in the beginning and month 11 of this study (CV = 0.036). CONCLUSION: Freeze-dried human and dog strong DAT positive sera are highly stable under different temperature conditions, are easy to transport and are safe for use as positive and negative serum controls in laboratories.