Application of CAR-T cell technology in autoimmune diseases and human immunodeficiency virus infection treatment.

Chimeric antigen receptor (CAR) T-cell therapy is an immunotherapy approach that has played a tremendous role in the battle against cancer for years. Since the CAR T lymphocytes are unrestricted-major histocompatibility complex T lymphocytes, they could identify more targets than natural T cells, resulting in practical and widespread functions. The good prospects of CAR T-cell therapy in oncology can be additionally applied to treat other diseases such as autoimmune and infectious diseases. CAR-T cell-derived immunotherapy for autoimmune disorders can be allocated to CAR-Tregs and chimeric autoantibody receptor T cells. Other generations of CARs target human immunodeficiency virus (HIV) proteins. In this review, we summarize CAR-T cell therapies in autoimmune disorders and HIV infection.

The relationship between general health and coping style with perceived stress in primigravida healthy pregnant women: Using the PATH model.

The aim of this study was to analyze relationships among general health, coping style, and perceived stress in healthy primigravida pregnant women. A cross-sectional study was conducted at public health clinics in Hamadan city, Iran between July and December 2015. In total, 380 pregnant women were selected through stratified random sampling. Data were collected using the Revised Prenatal Coping Inventory and General Health Questionnaire. Perceived stress was assessed through an interview comprised of open-ended questions. The final PATH model fit well; general health (ß = 0.02) as well as anxiety and sleep disorders (ß = 0.03) were slightly directly associated with perceived stress, and only planning-preparation was related to perceived stress through general health (ß = 0.09). The findings enhance the knowledge gained from previous perinatal stress research. General health status was directly related to stress, and coping style was indirectly related to stress. Coping styles may mediate the relationship between general health status and perceived stress, suggesting that midwives should attempt to improve the general health of women to reduce stress and its consequences during pregnancy by teaching patients appropriate coping styles. Further studies on the effect of coping style interventions on stress are warranted.

The effect of Valerian on the severity and frequency of hot flashes: A triple-blind randomized clinical trial.

Valerian is one of the most widely used herbal supplements and a phytoestrogenic herb. The aim of this study was to determine the effect of Valerian on the severity and frequency of hot flashes. This triple-blind, randomized, controlled clinical trial was conducted during a three-month period in Hamadan, Iran, in 60 postmenopausal women aged 45-55 years. Participants were randomly assigned to one of two groups- either placebo or Valerian. An oral Valerian 530 mg capsule was given twice per day for two months. An oral placebo 530 mg capsule (starch) was similarly administered. The severity and frequency of hot flashes were determined by the Kupperman index, before the intervention, one month after, and two months after initiation of the intervention. The severity of hot flashes in the Valerian group was significantly lower than that in the placebo group at one (p = .048) and two months (p = .020) after initiation of the intervention. Compared with the placebo group, the mean frequency of hot flashes was significantly reduced two months after initiating the use of Valerian (p = .033). Health-care providers should consider Valerian to be effective for menopausal women with hot flashes.

Effect of Menstrugole on primary dysmenorrhea: a randomized clinical trial.

OBJECTIVE: Primary dysmenorrhea occurs in more than 50% of women of reproductive age. This survey evaluated the effects of Menstrugole on the alleviation of primary dysmenorrhea. METHODS: This study was performed in western Iran between August 15 and December 15, 2017, in female students with primary dysmenorrhea. The students were randomly divided into 2 groups and received placebo or a Menstrugole capsule for 3 days in each of 2 menstrual cycles. The visual analog scale was used to assess pain severity. The χ2 test, one-way analysis of variance, and the paired t-test were used for statistical evaluation. RESULTS: We compared the severity of pain between the 2 groups. There was a significant change in the mean pain score during the first (P<0.001) and second months (P<0.001) after the use of Menstrugole, compared with that in the placebo group. CONCLUSION: Menstrugole decreased pain severity in female students, and can be considered by health care providers for treatment of primary dysmenorrhea.

Smoking and placenta previa: a meta-analysis.

OBJECTIVE: Previous studies found a positive association between placenta previa and smoking during pregnancy. However, the results of these studies are inconsistent. The aim was to perform meta-analysis of the association between smoking during pregnancy and placenta previa. METHODS: Major electronic databases, including PubMed, Web of Science, and Scopus were searched until June 2015. The heterogeneity across studies was explored by Q-test and I2 statistic. The possibility of publication bias was assessed using Begg's and Egger's tests. The results were reported using odds ratio (OR) estimate with its 95% confidence intervals using a random-effects model. RESULTS: The literature search yielded 991 publications until October 2015 with 9,094,443 participants. Based on the random effect model, compared to nonsmoker women, the estimated OR and RR of placenta previa was 1.42 (95% CI: 1.30, 1.54) and 1.27 (95% CI: 1.18, 1.35), respectively. CONCLUSIONS: There is sufficient documents based on the observational studies that smoking during pregnancy is significantly associated with an increased risk of placenta previa. Therefore, smoking during pregnancy can be considered as a predictor of placenta previa.

The association between maternal smoking and placenta abruption: a meta-analysis.

BACKGROUND: Several epidemiological studies have determined that maternal smoking can increase the risk of placenta abruption. To date, only a meta-analysis has been performed for assessing the relationship between smoking and placenta abruption. This meta-analysis was conducted to estimate the association between smoking and the risk of placenta abruption. METHODS: A literature search was conducted in major databases such as PubMed, Web of Science, and Scopus from the earliest possible year to April 2016. The heterogeneity across studies was explored by Q-test and I2 statistic. The publication bias was assessed using Begg's and Egger's tests. The results were reported using odds ratio (OR) estimate with its 95% confidence intervals (CI) using a random effects model. RESULTS: The literature search yielded 1167 publications until April 2016 with 4 309 610 participants. Based on OR estimates obtained from case-control and cohort studies, there was a significant association between smoking and placenta abruption (1.80; 95% CI: 1.75, 1.85). Based on the results of cohort studies, smoking and placenta abruption had a significant association (relative risk ratio: 1.65; 95% CI: 1.51, 1.80). CONCLUSIONS: Based on reports in epidemiological studies, we showed that smoking is a risk factor for placenta abruption.

Effects of Counselling and Sole Reflexology on Fatigue in Pregnant Women: A Randomized Clinical Trial.

INTRODUCTION: Increase of fatigue may lead to problems during pregnancy, delivery and post delivery. Sole reflexology is the application of pressure to areas on the feet. Reflexology is generally relaxing and may be an effective way to alleviate fatigue and stress. AIM: To investigate the effect of counselling and sole reflexology on fatigue in pregnant women, referred to the medical centers of Hamadan city, Iran. MATERIALS AND METHODS: This study was a randomized clinical trial with three groups - Group A (counselling and reflexology), Group B (reflexology) and Group C (control) with pre and post intervention. A total of forty two pregnant women were selected for each group. Measurement tool was a 30 question standard checklist for fatigue assessment. For all three groups, an explanatory session was held to get their written consents and conduct a pretest. The intervention included five education sessions, twice a week about reflexology in the form of counselling and sole reflexology. The groups were assessed immediately after intervention. Data were analysed using IBM SPSS Statistics 20.0. To analyse the data, descriptive statistics, t test and ANOVA with repeated measures were used. RESULTS: In group A and group B, the mean score of fatigue severity after the intervention demonstrated a significant decrease (p<0.05); furthermore, after intervention, a significant difference was observed between the control and experimental groups in terms of fatigue severity (p<0.01). CONCLUSION: Based on the results of this study, counselling and sole reflexology significantly decreased fatigue in pregnant women. It is hoped that the results of this study can be used by all treatment groups and midwives for controlling and providing midwifery cares for pregnant women.

Effects of Group Counseling Based on Health Belief Model on Cervical Cancer Screening Beliefs and Performance of Rural Women in Kaboudrahang, Iran

Objective: Pap smear test is an appropriate screening method for early diagnosis of cervical cancer and reduction of mortality. This study targeted effects of group counseling based on the Health Belief Model on cervical cancer screening practices of Iranian rural women. Method: This quasi-experimental study was conducted on 80 rural women under coverage of the health care centers in rural areas in the city of Kabudrahang, Iran, in 2015. The data collection tool was a researcher-made questionnaire covering demographic information, Health Belief Model (HBM) constructs and screening performance. Data were collected using a multi-stage sampling method. Group counseling was conducted based on the Health Belief Model and the GATHER steps in three sessions for the intervention group. Counseling included an introduction to cervical cancer, disease symptoms, warning signs and prevention approaches. Pap smear testing in both intervention and control groups was evaluated two months after the group counseling. Results: Before the intervention, there was no significant difference between both groups in the HBM constructs and performance. After the intervention, a significant difference was seen in the perceived susceptibility (P<0.001), severity (P=006), benefits (P=012), barriers (P<0.001), and self-efficacy (P=002). Two months after the intervention, 17 patients (42.5%) in the intervention group, and 4 patients (10%) in the control group had undergone a Pap smear test (P<0.001). Conclusion: Design and implementation of counseling programs based on the HBM can modify the beliefs of rural women regarding cervical cancer screening and increase their performance.

The limbo of motherhood: Women's experiences of major challenges to cope with the first pregnancy.

INTRODUCTION: pregnancy is a unique health experience which is influenced by various factors, particularly culture and social context. AIM OF STUDY: to explore women's perception regarding major challenges of adaptation with first pregnancy based on culture and social context. DESIGN: a qualitative content analysis was used for data gathering and analysis. Data were collected through unstructured in-depth interviews. SETTING: the study was conducted in public health clinics in Hamadan city, an urban area in southwest of Iran from July to December 2016. PARTICIPANTS: nineteen healthy primigravidas were recruited using a purposive sampling method and interviewed in the third trimester of pregnancy. FINDINGS: the two main categories extracted: imposing the motherhood role on oneself and negative feelings toward pregnancy. The feeling of being in limbo during pregnancy suggests that the everyday experiences of the participants were filled with challenges and short-term tensions, fears, and limitations of pregnancy overwhelmed the participants with negative feelings. As a result, they experienced doubt due to their inexperience in the acceptance of the responsibility of pregnancy and motherhood. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: one of the challenges of adaptation to pregnancy is the experience of negative feelings toward physiological changes and sense of uncertainty toward accepting motherhood responsibilities. Thus, the provision of suitable interventions during the prenatal period to reduce negative feelings and improve women's self-sufficiency in adaptation to pregnancy seems necessary.

Effect of calcium on premenstrual syndrome: A double-blind randomized clinical trial.

OBJECTIVE: Premenstrual syndrome (PMS) affects millions of women and is known as the most important disorder among them. The very aim of the present study was to evaluate the effects of low dose calcium on severity of PMS. METHODS: This study can be considered as a double-blind randomized clinical trial. Female students of Hamadan University of Medical Sciences diagnosed with PMS in 2014 participated in the present study. Sixty-six female students diagnosed with PMS were involved in the experimental and control groups. The participants were randomly assigned into two groups to receive 500 mg of calcium daily or placebo for two months. Severity of PMS was detected by Daily Record of Severity of Problems, which was used to measure symptoms during one menstrual cycle before and two menstrual cycles after the intervention. RESULTS: No signifcant differences were observed in the mean scores of PMS symptoms between calcium and placebo groups before the treatment (P=0.74). However, signifcant differences were noticed between the two intervention groups in the first (P=0.01) and second menstrual cycles (P=0.001) after the intervention. The differences were significant in subgroups of anxiety, depression, emotional changes, water retention, and somatic changes in calcium group compared with placebo group in the menstrual cycle before the intervention and two menstrual cycles after the intervention and among menstrual cycles (0, cycle 1, cycle 2) in calcium group (P=0.01). CONCLUSION: Overall, the results of the present study suggest that treatment with calcium supplements is an effective method for reducing mood disorders during PMS.

The Effect of Educational Program on Quality of Life in Menopausal Women: A Clinical Trial.

OBJECTIVES: This study aimed to investigate the effect of Educational program on quality of life (QOL) in menopausal women in 2016 in Hamadan, Iran. METHODS: In this clinical trial study, 100 postmenopausal women were randomly selected and allocated to case and control group (50 per group). Data collection tool included questionnaires of demographic information and Menopause QOL, which were completed by the samples before the intervention. In the case group, education program was run during 5 sessions for 45 to 60 minutes. Immediately and Three months after intervention, information were collected using questionnaire in both groups and they were analyzed using SPSS 16 software. RESULTS: The menopause women in both intervention and control groups had similar demographics. There was not a significant difference in the QOL mean scores in before of the intervention between the two groups of intervention and control in all dimension of QOL. There was a significantly difference in the mean of QOL scores between the two groups in immediately after the intervention and 3 months after the intervention in dimension of vasomotor, psychosocial, sexual and physical (P < 0.001). CONCLUSIONS: This study recommend that a unit in health and treatment centers be established for training menopausal women about health care by holding didactic classes.

A prospective study of genital infections in Hamedan, Iran.

A prospective study of genital infections was conducted in a university-affiliated teaching hospital in Hamedan City, Iran. A total of 540 women were recruited and divided into two equal groups: (1) the case group with vaginitis (N=270) and, (2) the asymptomatic control group (N=270). Participants were interviewed about the occurrence of any vaginal or urethral discharge. Two vaginal swabs were obtained for pH testing, KOH and wet mount examination, Gram staining and culture at the time of speculum examination. In the case group, the prevalence of candidiasis, trichomoniasis, and bacterial vaginosis was 17.2, 18.1, and 28.5%, respectively. Measurement of vaginal pH in the clinic was the single most useful clinical finding for directing empirical therapy. No single specimen was found ideal for all pathogens; a cervical swab is better for Trichomonas vaginalis but a vaginal swab is needed for candida and bacterial vaginosis. To achieve STD control in this and similar populations, public health programs must target asymptomatic infections.

Pediculus capitis infestation according to sex and social factors in Hamedan, Iran.

Pediculus capitis or head-louse infestation has been a worldwide public-health problem, especially among school-aged children. To determine the intensity of infestation (abundance) among schoolchildren, children's sex and social factors were analyzed as modifiers of the general prevalence of parasitism. The study included 847 schoolchildren (407 girls, 440 boys) aged 6-12 years, from 12 public rural primary schools of Hamedan, Hamedan Province, Iran. Classic prevalence was obtained as the percentage of children with nits and/or lice. The general prevalence was 6.85% (girls: 13.5%; boys: 0.7%, p<0.001), head lice were much more common in girls than boys. The results showed significant variations in head lice infestation, and factors such as parents' literacy, type of hair, previous infestation, sharing of bed and comb, and care centers, while there was no significant variation between school grade, parents' job, members of family, and pediculosis in the studied areas (p>0.05). Sex and social factors are important modifiers of P. capitis general prevalence and degree of infestation. The classification of children by intensity of infestation allowed a more precise delimitation of this condition, which is especially important for disease surveillance and application of control measures.

The association between polycystic ovary syndrome and breast cancer: a meta-analysis.

OBJECTIVE: The results of epidemiological studies investigated the association between polycystic ovary syndrome (PCOS) and the breast cancer are inconsistent. This meta-analysis was conducted to estimate the association between PCOS and the breast cancer risk. We searched PubMed, Web of Science, and Scopus for observational studies until June 2015. Data were independently extracted and analyzed using 95% odds ratio, and confidence intervals (CIs) based on the random-effects models. METHODS: We identified 970 references and conducted eight studies with 45,470 participants and 243,064 person- year. RESULTS: The association between PCOS and the breast cancer risk in case-control studies 0.87 (95% CI, 0.44 to 1.31) and that of cohort studies was estimated 1.18 (95% CI, 0.93 to 1.43). CONCLUSION: This meta-analysis demonstrated that PCOS no does increase the risk of breast cancer. Further prospective cohort studies are needed to provide convincing evidence in order to PCOS can increase or not effect on the risk of the breast cancer.

Effects of Group Training Based on the Health Belief Model on Knowledge and Behavior Regarding the Pap Smear Test in Iranian Women: a Quasi-Experimental Study.

The Pap smear test is recommended for early diagnosis of cervical cancer. The aim of this study was to assess knowledge and behavior regarding the Pap smear test based on the Health Belief Model (HBM) in women referred to premarital counseling classes, Hamadan, Iran. This quasi-experimental study was conducted on 330 women, who were allocated randomly to two case and control groups (n=165). Two educational session classes were performed in the case group. Two stages in before and after intervention groups were evaluated. Analysis of data was performed by SPSS/16.0, using t-test, x2, and McNemar's test. P-values <0.05 were regarded as significant. There was no significant difference between the mean scores of the various structures of this model in two groups before the intervention. However, after the intervention there were significant increase in mean score of knowledge and all variables of HBM in the intervention group(<0.001). The findings of this study highlight the important role of education about cervical cancer on changing women's beliefs about cervical screening.

Effect of Consultation and Educating in Preparation Classes for Delivery on Pregnancy Consequences: A Randomized Controlled Clinical Trial.

BACKGROUND: Care during pregnancy and performing consultation for delivery preparation play an important role in improving pregnant women's knowledge. OBJECTIVE: The purpose of this study was to investigate the effect of consultation and instruction in the preparation classes for delivery on pregnancy consequences, including choosing the type of delivery, the performed type of delivery, and infant's weight. METHODS: This study was conducted in 2015 on 170 pregnant women who had been referred to the prenatal clinic in Hamedan. The participants were randomly divided into intervention and control groups. Eight sessions of consultation for delivery preparation were held for the women in 20 to 36 weeks of pregnancy. The control group received only the routine care. After 37 weeks of pregnancy, the participants answered a questionnaire. The infant's weight was measured after birth. Data were analyzed Using SPSS-21 and McNemar-Bowker Test, independent t-test, chi-square test, and Fisher exact test. RESULTS: Results showed a significant statistical difference between the two groups concerning their selective and performed delivery (p<0.001). The weight of infants in the intervention group was significantly higher than that of those in the control group (p<0.001). CONCLUSION: The findings of this study showed that the consultation for delivery preparation had a positive effect on some pregnancy consequences such as selecting the type of delivery performed and infant's weight. TRIAL REGISTRATION: The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the IRCTID: IRCT2015012513405N9. FUNDING: The authors received no financial support for the research, authorship, and/or publication of this article.

The Impact of Aerobic Exercise on Quality of Life in Women with Breast Cancer: A Randomized Controlled Trial.

BACKGROUND: The women with breast cancer experience high rates of morbidity due to different treatments. The objective of this study was to evaluate the role of aerobic exercise in the quality of life (QoL) among women suffering from breast cancer in Hamadan, western Iran. METHODS: Participants who had consummated the eligibility criteria were randomly assigned in exercise group (n=30) and control group (n=30). Written informed consent was obtained from all participants. The mean age was 42.70 ±9.6 and 43.50 ±8.60 yr old in exercise and control groups, respectively. The quality of life was assessed by two widely used standard questionnaires (EORTC QLQ-C30 and EORTC QLQ-BR23). The exercise group received supervised exercise 2 days per week for 10 weeks. Through two stages (before and after intervention) these groups were evaluated. Analyzing the data was performed by SPSS/20.0, using t-test, chi-squared and ANCOVA. P<0.05 was regarded as significant level. RESULTS: The global health status QoL, based on EORTC QLQ-C30, developed significantly in the exercise group (48.76±24.96 vs. 81.79±16.34) in comparison with the controls (47.75 ±15.73 vs. 52.88 ±14.51) (P<0.001). The exercise intervention was associated with substantial development in total score of functions and symptoms of QoL using EORTC QLQ-BR23 (P<0.001). CONCLUSIONS: The statistically and clinically crucial developments were indicated in functions and symptoms of QoL in response to exercise in breast cancer women.

The Association between Body Mass Index and Hot Flash in Midlife Women: A Meta-analysis.

OBJECTIVES: The association between body mass index (BMI) and hot flash risk has not been specifically clarifies yet. This meta-analysis was, therefore, conducted to estimate the association between overweight and obesity and hot flash risk. METHODS: We searched PubMed, Web of Science, and Scopus for observational studies addressing the association between BMI and hot flash until August 2015. Data were independently extracted and analyzed using 95% odds ratio (OR), and confidence intervals (CI) based on the random-effects models. RESULTS: We identified 2,244 references and conducted seven studies with 4,219 participants. The association between hot flash and overweight was estimated 1.13 (95% CI: 0.97-1.32) and that of obesity was estimated 1.79 (95% CI: 1.52-2.11). No evidence of heterogeneity and publication bias was observed. CONCLUSION: This meta-analysis demonstrated that, though not to a great extent, obesity does increase the risk of hot flash. The findings from this meta-analysis indicated that obesity is associated with an increased risk of hot flash. Further large prospective cohort studies are required to provide convincing evidence as to whether or not BMI is associated with an increased risk of hot flashes.

Quality of Life in Postmenopausal Women in Iran: A Population-based Study.

OBJECTIVES: Menopause can have psychological, physical, and vasomotor symptoms along with sexual dysfunction and these symptoms can affect the quality of life (QOL). The purpose of this research was to determine and association the effective factors on QOL among postmenopausal Iranian women. METHODS: This cross-sectional study was conducted in 2015 on 300 postmenopausal women in Hamadan, Iran. We used the Menopause-Specific QOL questionnaire (MENQOL) for measuring QOL in postmenopausal women. SPSS version 16 was used for data analysis. RESULTS: The mean scores of QOL for vasomotor, psychosocial, physical, and sexual domains were 11.65 ± 5.93, 19.36 ± 1.20, 39.12 ± 1.95 and 11.02 ± 5.66, respectively. Higher scores had worse QOL. Using MENQOL scores, our study showed significant differences in QOL based on age, education level, financial status, number of children, employment, and body mass index (BMI). CONCLUSION: Menopause causes a decrease in QOL, which is dependent to age, work, BMI, financial status and number of children variables. Therefore, it is necessary to develop effective intervention programs to improve QOL in postmenopausal women.

Comparing the Effects of Agnugol and Metformin on Oligomenorrhea in Patients with Polycystic Ovary Syndrome: A Randomized Clinical Trial.

INTRODUCTION: Polycystic Ovarian Syndrome (PCOS) is the most common endocrinopathy and cause of oligomenorrhea in women. AIM: The present study was conducted with the aim to compare the effect of Agnugol and Metformin drugs on oligomenorrhea in patients with PCOS. MATERIALS AND METHODS: This study was a clinical trial on 120 women with PCOS and had oligomenorrhea, referring to a gynaecology clinic Fatemieh, Hamadan city, Iran, 2015. Women were randomly divided into 2 groups using permutation blocks (getting the medications Agnugol and Metformin) and were treated with drugs Agnugol and Metformin for 3 months. Data collection included demographic questionnaire and check list was designed and completed before and at the end of interventions, by both groups. To analyse the data, descriptive statistics, chi-square tests, t-test, ANOVA with repeated measures was used. RESULTS: The mean and SD of age was 39.45±4.60 for women taking Agnugol and 38.466±0.84 for those taking Metformin. Based on the results between the subjects, the two groups were not significantly different in terms of menstruation length, cycle intervals, or the number of pads, meaning that the two drugs had similar effects on menstrual cycle regulation, menstruation length and the number of pads. More side effects were reported in the group using Metformin. CONCLUSION: Agnugol and Metformin drugs in the treatment of oligomenorrhea patients with PCOS have the same effect. Since Metformin is a chemical drug with side effects, Agnugol can be presented as its herbal alternative to treat oligomenorrhea.