Severe Acute Respiratory Syndrome Coronavirus 2 Infection Symptoms in Pregnancy and Maternal and Neonatal Complications Due to COVID-19: A Systematic Review.

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in pregnant women is associated with severe maternal and neonatal complications including maternal and newborn death. Aims: This review aimed to assess the SARS-CoV-2 infection symptoms during pregnancy as well as maternal and neonatal complications in Iran. Settings and Design: A developing and low-income country and a systematic review. Materials and Methods: International scientific databases including PubMed, Web of Science, Scopus and Google Scholar were searched in a systematic review manner. Two independent researchers were checked and identified articles from September 2019 to September 2022 based on eligibility criteria and quality appraisal. The results of review were reported in two sections including maternal and neonatal outcomes. Statistical Analysis Used: Descriptive statistics was used for statistical analysis. Results: Seventeen studies including 870 pregnant mothers with COVID-19 met the eligibility criteria and were reviewed. The main maternal consequences of COVID-19 were intensive care unit (ICU) admission, pre-term delivery, maternal death, pre-mature rupture of membranes, pre-eclampsia, intrauterine growth retardation and stillbirth. Neonatal ICU admission, newborn death, neonatal sepsis, low birth weight and respiratory distress syndrome, tachypnoea, asphyxia and pneumothorax were the most common outcomes of COVID-19 infection in offspring of pregnant subjects. Conclusion: Pregnant mothers with COVID-19 infection are at higher risk of being admitted to the ICU and mechanical ventilation and consequently maternal and neonatal death. Comparing the maternal and foetal consequences in different ethnicities, regions and countries may be related to the socioeconomic status of people and should be considered with respect to different determines. Moreover, the maternal and neonatal complications due to COVID-19 infection in Iran and other developing countries seem to be higher than other countries.

Cultural Beliefs and Practices in Postpartum Women in Iran: A Qualitative Study.

Background: Cultural differences can be seen in the birth and postpartum period, where some traditional practices are used to protect the postpartum women and their newborns. The aim of this study was to investigate the cultural beliefs and practices of postpartum women. Materials and Methods: This was a qualitative study. Data were collected through semistructured in-depth interviews with a purposive sample of 20 mothers in Qom hospitals, Iran from 2019 to 2020. Interviews were transcribed verbatim and finally analysed through conventional content analysis. Results: Five themes of postpartum women's cultural beliefs and practices emerged from the data analysis including beliefs and practices related to public communications, women's postnatal care beliefs and practices, nutritional beliefs and practices, beliefs and practices pertaining to breastfeeding and infant care, as well as religious and traditional beliefs and practices. The most common cultural beliefs among women were beliefs related to public communications. Conclusion: Cultural and traditional postpartum beliefs and practices are common among postpartum women in Iran. To change postpartum behaviours, it is necessary to identify beliefs and practices first and then plan to correct wrong beliefs to achieve women's health in postpartum period.

Cancer resilience in parents of children with cancer; the role of general health and self-efficacy on resiliency.

Introduction: Cancer in children affect their parents to some stress and worries during treatment process. This study aimed to assess the parental adjustment on the resiliency of parents of children with cancer and its relationship with social support, self-efficacy, and general health. Materials and Methods: In a cross-sectional study, 107 parents of children with cancer were selected by convenience sampling method from the Oncology Departments of Qom Hospitals, Iran. Standard questionnaires including Phillips Social Support, Corner Davidson Resilience, Sheerer Self-Efficacy Inventory, and General Health Questionnaire (GHQ-28) were used for data collection. Pearson's correlation coefficient, Chi-square test, t-test, and multivariate linear regression were used for data analysis in SPSS software. Results: A significant correlation was observed between cancer resilience and social support score (r = 0.285). Multivariate regression model Showed that social support was the most important predictor of cancer resilience (ß =0.723, P = 0.045). In addition, self efficacy (ß =0.356, P = 0.005) showed a direct relationship with cancer resilience. Nevertheless, an inverse association (ß = -0.351, P = 0.025) was observed between GHQ score and cancer resilience in parents of children with cancer. Conclusion: Cancer resilience in families of children with cancer is significantly associated with higher social support, more self-efficacy, and better general health. Interventional programs aimed at increasing family resilience and reducing stress by increasing the social support and self-efficacy in patients' families are helpful and necessary.

Postpartum Multiple Colon Perforation after Cesarean Section in COVID-19 Patients: A Case Series.

Introduction: Gastrointestinal symptoms are present in 50% of polymerase chain reaction (PCR)-positive COVID-19 patients. In addition, bowel abnormalities are a common finding of COVID-19, and bowel-wall disorder is reported in 31% of computed tomography images of COVID-19 patients. Case History: We report three postpartum cases with colon perforation after Cesarean section and positive PCR for SARS-CoV-2-RNA and during the main peak of COVID-19 pandemic, who were managed by early detection, laparotomy, and effective treatment and were discharged and followed up. Conclusion: A colonic perforation could be considered as one of the causes of abdominal pain especially in women with a past surgical history as well as patients with infectious diseases such as COVID-19. Therefore, abdominal and pelvic ultrasound or x-ray was strongly recommended for postpartum women with abnormal abdominal distension, gastrointestinal symptoms, and pain to prevent possible fetal complications.

An investigation of the effects of environmental and ecologic factors on cutaneous leishmaniasis in the old world: a systematic review study.

OBJECTIVES: Leishmaniasis is a neglected and widespread parasitic disease that can lead to serious health problems. The current review study aimed to synthesize the relationship between ecologic and environmental factors (e.g., weather conditions, climatology, temperature and topology) and the incidence of cutaneous leishmaniasis (CL) in the Old World. CONTENT: A systematic review was conducted based on English, and Persian articles published from 2015 to 2020 in PubMed/Medline, Science Direct, Web of Science and Google Scholar. Keywords used to search articles were leishmaniasis, environmental factors, weather condition, soil, temperature, land cover, ecologic* and topogr*. All articles were selected and assessed for eligibility according to the titles or abstracts. The quality screening process of articles was carried out by two independent authors. The selected articles were checked according to the inclusion and exclusion criteria. SUMMARY AND OUTLOOK: A total of 827 relevant records in 2015-2020 were searched and after evaluating the articles, 23 articles met the eligibility criteria; finally, 14 full-text articles were included in the systematic review. Two different categories of ecologic/environmental factors (weather conditions, temperature, rainfall/precipitation and humidity) and land characteristics (land cover, slope, elevation and altitude, earthquake and cattle sheds) were the most important factors associated with CL incidence. CONCLUSIONS: Temperature and rainfall play an important role in the seasonal cycle of CL as many CL cases occurred in arid and semiarid areas in the Old World. Moreover, given the findings of this study regarding the effect of weather conditions on CL, it can be concluded that designing an early warning system is necessary to predict the incidence of CL based on different weather conditions.

Environmental and ecological factors of stomach cancer incidence and mortality: a systematic review study on ecological studies.

OBJECTIVES: Stomach cancer (SC) is one of the most common and deadly types of cancer. It is the third leading cause of cancer deaths worldwide. The effect of environmental and ecological factors in SC have been assessed in some studies. Thus, we aimed to synthesize the environmental and ecological factors of SC incidence and mortality. CONTENT: In this systematic review study, the scientific databases, including Web of Science, Scopus and PubMed, were searched from inception to November 2019 for all primary articles written in English by using relevant Medical Subject Heading (Mesh) terms. Two independent authors conducted the screening process to decide on the eligibility and inclusion of the articles in the study. The third author acted as an arbiter to resolve any disagreements. SUMMARY AND OUTLOOK: A total of 157 potentially relevant articles were identified from the initial search 38 of which met the eligibility criteria; finally, 34 articles were included in the systematic review. The results revealed that soil arsenic exposure, coal and other opencast mining installations, living near incinerators and installations for the recovery or disposal of hazardous waste, installations for the production of cement, lime, plaster, and magnesium oxide, proximity to a metal industry sources, dietary iron, ingested asbestos, farming, arsenic in soil, altitude, organochlorines and environmental exposure to cadmium and lead have positive associations with SC incidence or death. Most of the ecological and environmental factors such as living near the mineral industries, the disposal of hazardous waste, metal industry sources and environmental exposure to cadmium and lead are positively related to SC mortality and incidence. However, solar UV-B, heat index and dietary zinc can be taken into account as protective factors against SC mortality and incidence.

Estimation of the wastage rate of MMR and pentavalent vaccines in open and closed vials in three western provinces of Iran.

BACKGROUND: Vaccine wastage is one of quality indicators of immunization program and high vaccine wastage will increase overall costs and impede efforts towards a more efficient and sustainable program. We aimed at estimating of the wastage rates of Measles-Mumps-Rubella (MMR) and pentavalent (diphtheria-tetanus-pertussis-hepatitis B -Haemophilus influenza type b) vaccines in different vaccine vial sizes. STUDY DESIGN: Multicentre descriptive study using existing data. METHODS: This study was in three provinces (Hamadan, Kermanshah and Kordestan) of Iran including 131,135 populations with 2,548 under-1years children. Twenty-seven health facilities were selected randomly from nine districts in three provinces of western part of Iran. Six-months data including vaccination and vaccine stock records collected from April to September 2017. Finally, number of opened vials and number of target population vaccinated were collected and data were analysed to estimate the wastage rates in both unopened and opened vials of both antigens. RESULTS: The wastage rate for combined MMR 2-dose and 5-dose opened vials for three provinces was 29%(Hamadan 18%, Kermanshah 14% and Kordestan 52%). The wastage rate for combined pentavalent single-dose and 10-dose vials for three provinces was 17% (in Kordestan33%, 11% Kermanshah 11% and Hamedan 3%). The total average of pentavalent single-dose and 10-dose vials wastage rate was 5% and varied 13% for urban and 3% for rural areas. The average of discarded unopened vials wastage rate in all facilities for MMR was 3.9% (3.2% for MMR 2-dose vial and 10.2% for MMR 5-dose vial). This rate was 1.7% for pentavalent total (1.9% for single dose vial and 0.4% for 10 dose vial). CONCLUSION: The vaccine wastage rates in Iran are in line with other countries and lower than the suggested rate based on WHO policies for multi-dose vials. The wastage rates were different for in provinces, districts and health facilities. The MMR total wastage rate in rural is higher than those in urban areas. However, the pentavalent total wastage rate was higher in urban area.

The Failure Rate, Related Factors, and Neonate Complications of Vaginal Delivery after Cesarean Section.

BACKGROUND: The rate of Cesarean Section (CS) is high in Iran. A successful Vaginal Birth After Cesarean (VBAC) section can protect mothers against the risk of having multiple CS. This study aimed to evaluate the success rate of VBAC, related factors, and the causes of failure. MATERIALS AND METHODS: This cross-sectional study was conducted on 150 pregnant women who were candidates for VBAC and admitted at maternity hospitals in Qom from 2016 to 2018. The required data were collected from the patients' records and entered into the checklist. Then, the success rate of VBAC was estimated, and related factors together with the causes of failure were determined by t-test, Chi-square, and independent-samples t-tests in SPSS v. 18 software. RESULTS: The mean (SD) maternal age was 32 (5.20) years and ranged from 21 to 45 years old. The success rate of VBAC was estimated to be 85.33%, and 14.67% of the patients had to repeat a CS after failure in vaginal delivery. The mean time between previous CS and present delivery was statistically significant between successful and failure groups (t 125 = 2.32, p = 0.002). The results also revealed that the most important causes of VBAC failure were prolonged labor [odds ratio (OR) = 4.70)], full arrest (OR = 2.70), and decline fetal heart (OR = 5.31). CONCLUSIONS: The success rate of VBAC in our study was high. However, VBAC was more successful when the interval between inter-deliveries was long, and lower complications were reported when the interval was 2-4 years.

Translation, Validation, and Psychometric Properties of Breastfeeding Self-Efficacy Scale-Short Form Among Iranian Women.

BACKGROUND: Iranian researchers have investigated breastfeeding self-efficacy and its related factors. However, there is no valid and reliable tool for assessing the breastfeeding self-efficacy of Iranian Farsi-speaking women. RESEARCH AIM: To examine the validity and reliability of the Breastfeeding Self-Efficacy Scale-Short Form among Iranian Farsi-speaking mothers. METHODS: We conducted this cross-sectional study at Izadi teaching hospital in Qom, Iran. Using convenience sampling, we recruited 174 mothers, who completed the questionnaire on the first postnatal day. A forward-backward translation method was used to translate the scale. Cronbach's alpha and item-total characteristics were examined to test reliability. Construct validity was evaluated via principal component analysis (PCA), as well as known-groups validity. RESULTS: The mean (standard deviation) of sample age was 28.33 (5.38). The mean (standard deviation) of breastfeeding self-efficacy score was 54.32 (10.50), ranging from 24-70. Cronbach's alpha (.92), inter-item correlations (.21-.72), and corrected item-total correlations (.44-.75) indicated the adequate reliability of the scale. PCA yielded one component with an eigenvalue of 6.97, explaining 49.8% of the total variance. There was no significant difference in the self-efficacy scores between primiparous and multiparous women. Breastfeeding self-efficacy was not significantly different between the groups in terms of the demographic characteristics. CONCLUSION: The Farsi version of the Breastfeeding Self-efficacy Scale-Short Form is a valid and reliable instrument for Iranian Farsi-speaking mothers, with sound psychometric properties per the other studies worldwide.

The spatial analysis of annual measles incidence and transition threat assessment in Iran in 2016.

Background: During the past years, due to the increase in immunization coverage and promotion of surveillance data, the incidence of measles decreased. This study aimed to determine the measles incidence risk, to conduct spatial mapping of annual measles incidence, and to assess the transition threat in different districts of Iran. Methods: A historical cohort study with retrospective data was conducted. The measles surveillance data containing 14 294 cases suspected of having measles in Iran were analyzed during 2014-2016. WHO Measles Programmatic Risk Assessment Tool was applied to calculate and map the incidence of measles in each district, to determine the annual incidence rate, and to conduct spatial threat assessment risk. Threat assessment was measured based on factors influencing the exposure and transmission of measles virus in the population. The annual measles incidence rate and spatial mapping of incidence in each Iranian district was conducted by Measles Programmatic Risk Assessment Tool. Data were analyzed by descriptive statistics in Excel 2013 and Arc GIS 10.3. Results: Of 14 294 suspected cases, 0.6% (CI 95%: 0.599-0.619) were identified as clinically compatible measles, 0.280 (CI 95%: 0.275-0.284) as confirmed rubella, 0.52% (CI 95%: 0.516-0.533) as epi-linked measles, 4.6% (CI 95%: 0.450-0.464) as lab-confirmed measles, and 94% (CI 95%: 93.93-94.11) were discarded. The annual incidence rate in cases per 100 000 populations increased from 0.0726, (CI 95%; 0.0714-0.0738) in 2014 to 0.1154 (CI 95%; 0.1135-0.1173) in 2016, and the 3-year incidence rate during the study period was 1.032 (CI 95%; 1.017-1.047) and the annual average was 0.3442 (CI 95%; 0.3387-0.3496). Conclusion: The average annual incidence rate of measles in Iran was low, but after a 11-fold increase in the number of measles cases in 2015, the number of measles cases decreased to more than 7-times in 2016. However, maintaning a high immunization coverage of measles and timely vaccination can be effective in reaching the goal of measles elimination.

Intimate partner violence against Iranian women.

Background: . WHO has identified intimate partner violence (IPV) as a health priority as it has considerable consequences on the physical and psychological health of women. We aimed to evaluate the prevalence of IPV in women of one of the central cities of Iran in addition to examining the effect of a women's job and spousal addiction on IPV. Methods: We did a cross-sectional study on 240 homemakers and nurse women, selected by a multistage random sampling method. Data were collected by a modified version of domestic violence CTS-2 of Straus questionnaire and were analysed by chi-square test and t test. Multivariate logistic regression was used to assess the predictors of physical IPV as the most important type of violence. Results: The mean (SD) age of the women and their husbands was 33.1 (8) and 37.8 (8.7) years, respectively. Verbal (95.4%) and psychological (80.8%) violence were the most common while injury (14.6%) was the least prevalent. The prevalence of physical violence was 28.8%. Based on the regression model, economic problems, history of divorce in the woman's family and spousal addiction were the highest predictors of violence (p<0.05). Discussion: Spousal addiction was related to higher violence against women in physical, psychological and injury dimensions. Increase of family support, removal of economic disparities and tackling drug addiction could be effective in decreasing violence.

Estimation of measles risk using the World Health Organization Measles Programmatic Risk Assessment Tool, Iran.

INTRODUCTION: Based on the World Health Organization (WHO) reports the EMRO countries did not reached to eradication of measles at 2010. This study aimed to estimate the risk of measles outbreak in different districts of Iran to identify high-risk areas based on WHO measles programmatic risk assessment tool. MATERIALS AND METHODS: The WHO measles programmatic risk assessment tool was used to estimate the overall risk of measles in 31 providences and 322 districts of Iran at 2017. The measles risk was calculated by a function of four indicator scores including population immunity, surveillance quality, program performance, and threat assessment and the overall risk of measles for each districts calculated. Then, the tool assigned each district a risk category of low, medium, high, or very high according to the overall risk score. RESULTS: Of the 322 districts in Iran, all districts were categorized as low risk and there was no very high risk, high risk and medium risk district in Iran. Twenty-six districts (7.4%) received to risk point higher than 20. Based on population immunity and program delivery performance indicators, all districts in Iarn were categorized as low risk and 92.86% of districts were in low risk category by surveillance quality indicator. CONCLUSION: The overall risk of measles profile was categorized as low risk and Iranian practices for measles elimination is very good in comparing other studies in this area. However, more attempts should be conducted to sustaining the surveillance quality indicators in all districts.

Negative Religious Coping, Positive Religious Coping, and Quality of Life Among Hemodialysis Patients.

BACKGROUND: Religious coping is known as a main resource influencing how individuals cope with the complications and stressors of chronic disease. OBJECTIVES: The aim of this study was to assess the relationship between religious coping and quality of life among hemodialysis patients. METHODS: This cross-sectional study was conducted in Qom, Iran, from June 2012 to July 2013. Ninety-five end-stage renal disease (ESRD) patients undergoing hemodialysis were selected via the convenience sampling method. Data were collected via a questionnaire comprising items on sociodemographic information, quality of life, the anxiety and depression scale, and religious coping. Following this, the data were analyzed using descriptive statistics and logistic regression analysis. RESULTS: The mean age of patients was 50.4 (standard deviation [SD] = 15.7) years, and most were male (61%). The mean score for positive religious coping was 23.38 (SD = 4.17), while that for negative religious coping was 11.46 (SD = 4.34). It was found that 53.6% of patients had higher than the mean score of positive religious coping, while those with negative religious coping made up 37.9%. Negative religious coping was associated with worse quality of life, including physical functioning (odds ratio [OR] = 0.72; P = 0.009), role physical (OR = 0.79; P = 0.04), vitality (OR = 0.62; P = 0.005), social functioning (OR = 0.69; P = 0.007), and mental health (OR = 0.58; P = 0.01) after controlling for sociodemographic, clinical, and anxiety and depression variables. CONCLUSIONS: The results indicated that patients with negative religious coping abilities were at risk of a suboptimal quality of life. Incorporating religious support in the care of hemodialysis patients may be helpful in improving quality of life in this patient population. Further longitudinal studies are needed to determine whether these associations are causal and the direction of effect.