The association of sociodemographic factors and history of chronic diseases on menopausal symptoms: A cross-sectional study.

Background: Menopausal symptoms are very diverse in terms of prevalence and severity, and this difference is due to various factors such as psychological factors, sociocultural status, lifestyle, geographical location, and other factors. This study aimed to assess the prevalence of menopausal symptoms and evaluate the predictive factors related to the prevalence and severity of menopausal symptoms. Materials and Methods: This was a cross-sectional analytical study that was performed on 214 women aged 35-65 years old who were referred to Alzahra Educational, Research and Treatment Center in Rasht, Iran. The data collection tool was a valid and reliable questionnaire, using the list of menopausal symptoms and a checklist of subjects' general characteristics. Results: 16.8% of postmenopausal women in our study had at least one menopausal symptom. Using multiple linear regression, race (p = 0.02), history of chronic diseases (p = 0.04), place of residence (p = 0.02), and marital satisfaction (p = 0.02) were associated with menopausal symptoms. Nineteen percent of the covariates related to the logistics function were explained by the predictor variables in the model. Conclusion: Evaluation of menopausal symptoms showed that the severity of menopausal symptoms was related to factors such as body mass index (BMI), ethnicity, place of residence, marital satisfaction, and history of chronic diseases, and need to address BMI, psychological issues, and chronic illness.

Levels of serum ß-human chorionic gonadotropin after embryo transfer and subsequent miscarriage, pre-eclampsia, and intrauterine growth restriction.

Background: This study aimed to examine maternal serum concentration of ß-human chorionic gonadotropin (ß-hCG) on Day 16 after embryo transfer and risk of miscarriage, pre-eclampsia, and intrauterine growth restriction (IUGR). Methods: In this study, we evaluated 125 pregnancies following in vitro fertilization (IVF). ß-hCG concentrations were measured on the morning of Day 16 after embryo transfer. Baseline characteristics of the study participants were also recorded. Results: Concentrations of ß-hCG on Day 16 after embryo transfer were inversely associated with the higher risk of miscarriage (p < 0.001), but did not with pre-eclampsia and IUGR (p > 0.05). Spearman's correlation coefficient showed a reverse and significant association between ß-hCG and higher risk of miscarriage (σ = 0.531 and p < 0.001). There was a significant association between frozen embryo transfer and the risk of IUGR and pre-eclampsia (p = 0.005 and p = 0.023, respectively). Conclusions: Maternal serum concentrations of ß-hCG on Day 16 after IVF/embryo transfer were associated with the higher risk of miscarriage, but not pre-eclampsia and IUGR.

The role of diabetic foot treatment in improving left ventricular function: Insights from global longitudinal strain echocardiography.

We decided to evaluate the effect of treatment of diabetic foot ulcers in improving heart function by strain echocardiography than conventional transthoracic echocardiography. This prospective cross-sectional study included patients with diabetic foot ulcer (DFU). Conventional and two-dimensional strain echocardiography performed before and after three months diabetic foot treatment. Then, we compared the echocardiographic parameters including left ventricular ejection fraction (LV-EF), left ventricular global longitudinal strain (LV-GLS). Multivariate and univariate logistic regression analysis were performed to find which variable was mainly associated with LV-GLS changes. 62 patients with DFU were conducted. After echocardiography, all patients underwent surgical or non-surgical treatments. Three months after the treatment, LV-EF was not significantly different with its' primary values (P = 0.250), but LV-GLS became significantly different (P<0.05). In the multivariate logistic regression analysis, with the increase in the grade of ulcer, LV-GLS improved by 6.3 times. Not only the treatment of DFU helps to control adverse outcomes like infection, limb loss and morbidity but also it enhances cardiac function. Of note, strain echocardiography found to be a better indicator of myocardial dysfunction than LV-EF. These findings make a strong reason for the routine assessment of cardiac function in patients with DFU.

Clinical and historical features of cesarean scar pregnancies in a tertiary hospital with a high rate of cesarean section: A case-control survey.

Background and Aims: Cesarean scar pregnancy (CSP) is a rare medical condition accounting for 1:2000 of all pregnancies with prior history of cesarean deliveries (CS). As the rate of CS is increasing worldwide, it is important to know the nature of CSP and its complications. Methods: In this retrospective case-control study, we evaluated 264 pregnant women; 86 cases with ultra-sonographic findings of CSP and 178 controls: normal pregnancies with gestational age less than 12 weeks. The variables consisted of demographic characteristics, the features and causes of the prior CS, the time distance to the current pregnancy, sonographic features, and the final management. All data analyzed using SPSS version 21. Results: There was a significant difference between the two study groups regarding to parity, abortions and D&Cs (p < 0.001). In the case group, 19.8% of patients had positive results for STDs versus 16.3% in the control group (p > 0.990). The mean average of intervals between the last CS and current pregnancies were 48.22 ± 37.03 in the case group versus 61.25 ± 36.25 months in the control group (p < 0.001). Regression Logistic analysis showed advanced maternal age (p < 0.001), positive history of abortions and D&C (p < 0.001), elective type of prior c/s (p < 0.001) and the short time interval between prior CS and current pregnancy (p < 0.001) could significantly predict the patients at higher risk of presenting CSP in the case group. Conclusions: Based on our findings, advanced maternal age, positive history of abortion, the elective type of the former CS, and short time intervals between previous CS and current pregnancy are the main risk factors of CSP.

Quality of spirometry tests in the field of occupational health.

BACKGROUND: The spirometry test is a valuable test to evaluate the performance of the respiratory system. The interpretation of the results is highly dependent on the quality of its performance, while the inappropriate quality results in unwanted consequences for individuals and the healthcare system. This study investigated the quality of spirometry tests performed in occupational health. METHODS: In this cross-sectional study, the quality of 776 spirometry tests in different occupational centers by the specialists in Rasht, Iran, in 2020, based on the guidelines of the American Thoracic Society (ATS), was investigated. The quality and success rate of the test and the demographical characteristics of the operators and the participants were collected. All data was analyzed using SPSS software version 20. RESULTS: Out of 776 spirometry tests, about 69.7% were unacceptable. Among the unacceptable tests, a pause error between inhalation and exhalation was identified in 7.4% of tests. Additionally, 4.6% of the unacceptable tests exhibited a cough error within the first second, while an exhalation error of less than six was observed in 85%. Repeatability errors were found in 60.9% of the tests. Furthermore, among some errors, the communication error between the characteristics of the technicians and the test performance errors were evident. CONCLUSION: According to the results, most of the performed tests were unacceptable with no repeatability, which indicated that the validity and quality of spirometry tests and their interpretation were inappropriate in the field of occupational health in Rasht, Iran.

Evaluation of the Spiral Chest CT Scan Findings in Patients with Multiple Trauma.

Objective: To evaluate the spiral chest computed tomography (CT) scan findings in patients with multiple trauma during the COVID-19 pandemic. Methods: This retrospective study was performed on multiple trauma patients admitted to a tertiary hospital in the north of Iran in 2020. All patients with multiple trauma who had undergone a chest spiral CT were included in this study. Furthermore, the data analysis was performed through descriptive and analytical statistics using SPSS software. Results: A total of 600 patients were included over the study period. The mean age of patients was 48.2±20.3 years. Of the total, 496 (65.3%) patients had blunt chest injuries, and 104 (34.7%) had penetrating chest injuries. Falling was the most common mechanical cause of chest trauma in 270 patients (45%). Surgical interventions were performed in 110 (18.3%) patients. A total of 276 (46%) patients had chest injuries identified by CT scans. Many patients (15.6%) had ground-glass lung opacity in the CT scan reports. Lung consolidation, pneumothorax, lung contusion, hemothorax, and rib fractures were the most common. Conclusion: Due to the high frequency of typical findings in spiral CT scan examinations, obtaining a reliable history of trauma severity, injury mechanism, and a detailed physical examination is recommended before prescribing a CT scan for patients.

The prevalence of endometrial polyp in women with tubal factor infertility is higher than male factor infertility: Is PID one of the causes of endometrial polyp?

AIMS: Previous studies have shown an association between chronic endometritis and endometrial polyps, and only one study in infertile women reported an association between tubal obstruction and polyps. This study aimed to compare the prevalence of endometrial polyps in two groups of women with tubal factor infertility and male factor infertility to assess if is there any association between tubal factor infertility and endometrial polyps. METHODS: This case-control study was performed on infertile women. The case group included women with tubal factor infertility and the control group included all women with male factor infertility. In all patients, vaginal ultrasound was performed between days 8 and 12 of the menstrual cycle to diagnose endometrial polyp, its size, and number. Demographic and obstetrics variables were recorded. Patients underwent hysteroscopy and polypectomy and the diagnosis of the polyp was confirmed by pathology report. RESULT: In the present study, 245 people participated in two groups. There was a statistically significant difference between the two groups in terms of demographic and obstetric characteristics like type of infertility, duration of infertility, and gravidity. The prevalence of polyps in the tubal factor group was higher than in the male factor group (63 [60%] vs. 12 [9.8%]), and this difference was statistically significant (p = 0.0001). In addition, the prevalence of chronic endometritis in the tubal factor group was higher than in the male factor group (19 [18.8%] vs. 4 [3.3%]), and this difference was statistically significant (p = 0.001). CONCLUSIONS: In the present study, a strong association was observed between endometrial polyps and tubal obstruction, and considering that the most common cause of tubal obstruction is pelvic and genital infections, after confirmation with more studies, it may be possible to consider antibiotic treatment in these patients, especially in patients with recurrent polyps.

Traumatic injuries in children during COVID-19 pandemic: a national report from northern Iran.

BACKGROUND: There are no comprehensive and accurate statistics on epidemiology and clinical features, especially during the COVID-19 period. The present study tries to describe the pediatric traumas in a referral treatment center in northern Iran during the COVID-19 period and to compare the available statistics with the years before pandemics to examine the differences in the epidemiology of this event in our country. METHODS: This cross-sectional study was performed on 543 children under 15 years admitted to this hospital due to different types of traumas in the first six months of 2019 (before the COVID-19 pandemic) and the first six months of 2020 (coinciding with the peak of the pandemic). The information was retrospectively collected by reviewing the hospital recorded files and the trauma-specific hospital information system. RESULTS: In total, 436 children were referred before the COVID-19 pandemic period and 107 within the pandemic outbreak. The peak age of patients admitted was 2 to 6 years (32.0%) and 70.5% were male. Most of the pointed children had normal weight. The most common mechanism of trauma before and during the COVID-19 pandemic was falling from a height (46.3% versus 42.1%), followed by road accidents (35.6% versus 36.4%). The overall prevalence of penetrating trauma was 6.9% and 9.3%. The most common body sites affected were the head and neck (32.1%) followed by extremities (before the COVID-19 period) and extremities (29.0%) followed by the head and neck (24.3%) (in the COVID-19 period). The overall rates of multiple trauma before and within the pandemic were also 35.6% versus 35.5%. In children aged 12 to 15 years, road accidents were more reported during the COVID-19 pandemic period (68.4% versus 50.9%) and contrarily falling from a height more before the pandemic (25.5% versus 0.0%). In children under two years of age, head and neck trauma was more reported before the COVID-19 period than in the COVID-19 period (55.6% versus 35.5%), while at this age, limb trauma was more common during the COVID-19 period than before (5.6% versus 20.8%) (P = 0.043). In lean children, abdominal and pelvic trauma were mainly seen in the COVID-19 period (28.6% versus 2.6%) (P = 0.035). CONCLUSION: Referrals of children from traumatic injuries decreased during the COVID-19 period. However, the main differences in the mechanism of trauma and the type and severity of traumatic injuries to children in this period emphasize the provision of specific guidelines for trauma management in children.

Traumatic brain injuries in children during COVID-19 pandemic: a national report from northern Iran.

BACKGROUND: Evidence suggests that referral cases of traumatic injuries have decreased during the COVID-19 pandemic both in childhood and in adulthood. Still we have very little evidence of referrals due to traumatic brain injury among children during the COVID-19 outbreak. The present study aimed to describe epidemiological and clinical features of pediatric traumatic brain injuries. METHODS: This cross-sectional study was performed on all patients under 15 years with any evidence of head trauma, referring to Poursina teaching hospital, a referral center for trauma and road accidents in northern Iran. The patients' data were retrospectively collected by reviewing the hospital recorded files and the trauma-specific hospital information system. RESULTS: Of all 543 pediatric traumatic injuries referred to our hospital during the two pointed periods, 166 had any evidence of head and neck injuries leading to an overall prevalence rate of 30.6%. In this regard, the prevalence rate of head/neck injuries was estimated to be 140 out of 436 within a pre-COVID-19 period (32.1%) and 26 out of 107 within the COVID-19 period (24.3%) indicating no significant difference between the two time periods (P = 0.243). However, assessing the rate of head/neck injuries pre-COVID-19 and COVID-19 periods according to patients' age showed a higher rate of such injuries in pre-COVID-19 as compared to COVID-19 periods in patients aged less than two years (55.6% versus 37.5%, P = 0.013) as well as aged 2 to six years (45.8% versus 30.0%, P = 0.036). CONCLUSION: The rate of admission of children due to traumatic brain injury during the COVID-19 period does not show a significant change compared to before, and only in children under 6 years of age a decrease in referrals due to brain trauma during the COVID-19 period was observed.

Investigation of clinical findings and CT scan in children with minor head trauma.

BACKGROUND: The most common cause of death or severe impairment in children older than one-year-old is traumatic brain injury (TBI). Assessing TBI in children with minor head trauma (MHT) using clinical findings from history-taking and a physical exam is crucial to minimizing unnecessary brain CTs and more accurately predicting TBI. We aimed to evaluate the findings of brain CT scans in children with mild head trauma and their relationship with clinical signs and symptoms to avoid unnecessary interventions in many children with MHT. METHODS: This cross-sectional-analytical study was performed to evaluate the findings of brain CT scans in children with MHT and their relationship with clinical signs and symptoms that were referred to Poursina Hospital in Rasht in the first half of 2021. Children were divided into two age groups: under two years and 2-12 years, and analyzed separately. Initially, a list containing all demographic information, patients' clinical signs, and symptoms were prepared. The collected data were then analyzed using SPSS software version 26. RESULTS: According to the results, the mean age of patients was 66.01 months and 88 were boys (56.4%). The most common mechanism of injury was falling from a height. Most patients had isolated head injuries. Among the accompanying injuries, facial injuries were the most common. Among the clinical factors studied, cranial fracture on CT scan and GCS less than 15 were significantly associated with the occurrence of traumatic brain injury on CT scan. In addition, cranial fracture on CT scan, injury severity, and history of vomiting had the highest positive predictive value, respectively. CONCLUSION: Standard history and clinical examination are sufficient to identify high-risk cases of pediatric head injuries. GCS is the most important risk factor for pediatric MHT. Requesting a CT scan is not recommended without these risk factors.