Global prevalence of urinary tract infection in pregnant mothers: a systematic review and meta-analysis.

OBJECTIVE: Urinary tract infection (UTI) is a prevalent infection during pregnancy that can lead to complications for both the mother and the foetus. The objective of this systematic review and meta-analysis is to determine the global prevalence of UTIs (both symptomatic and asymptomatic) during pregnancy, based on previous studies in this area. Furthermore, this study aims to identify any factors that contribute to heterogeneity in the prevalence of UTIs during pregnancy. STUDY DESIGN: Systematic review and meta-analysis. METHODS: This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines on August 8, 2022. To conduct the systematic review and meta-analysis, a search was performed using the keywords "urinary tract system", "UTI", "pregnancy", and "gestation" was performed in several databases, including Web of Science (WoS), PubMed, Scopus, ScienceDirect, Embase, and Google Scholar, without a time limit until September 18, 2022. The analysis was performed using a random-effects model, and the heterogeneity of the studies was assessed using the I2 index. The Comprehensive Meta-Analysis software (Version 2) was used for data analysis. RESULTS: The systematic review and meta-analysis of 27 studies, which included a total of 30,641 pregnant women, showed an overall prevalence of UTI (both symptomatic and asymptomatic) to be 23.9% (95% confidence interval: 16.2-33.8). Meta-regression analysis was conducted to examine the impact of two factors, namely study sample size and study year, on the heterogeneity of the meta-analysis. The results revealed that an increase in sample size, and the study year was associated with a decrease in the prevalence of UTI in pregnant women (P < 0.05). CONCLUSION: The results of our study indicate a global prevalence of UTI in pregnant women to be 23.9%. Therefore, it is recommended that all pregnant women undergo regular UTI screening tests and receive prompt treatment if diagnosed with UTI. Early detection and treatment of UTI during pregnancy are crucial to prevent complications that may affect the health of both the mother and the foetus.

The Modified Hospital Elder Life Program (HELP) in geriatric hospitalized patients in internal wards: A double-blind randomized control trial.

BACKGROUND: Hospital Elder Life Program (HELP) provides protocols based on factors for reducing delirium. Due to the lack of geriatric wards and aged care teams in Iran, it seems that some of the original HELP interventions need to be modified through a trial study. Hence, this study was conducted to determine whether the Iranian modified HELP could reduce delirium in geriatric hospitalized patients. METHODS: This double-blind randomized controlled trial was designed and conducted in a hospital at Kashan University of Medical Sciences in Iran. A total of 195 hospitalized patients aged ≥70 years, were 84 in the Intervention Group (IG) and 111 in the Control Group (CG). After assessing delirium risk factors, participants in the IG group received interventions based on the cognitive, vision/hearing, sleep, mobility, feeding, and hydration protocols by nursing students and the CG group received routine care. Delirium incidence was assessed by the Confusion Assessment Method. Delirium incidence, cognitive and functional abilities, frailty, fall, and length of stay were outcomes. RESULTS: The mean age of the patients was 78.53(Standard Deviation = 5.87) years. Delirium incidence was higher in the CG comparing to IG (14.71% vs 3.66%).Significant reduction observed in risk incidence of delirium because of interventions [Odds Ratio:0.124, Confidence Interval: 0.03-0.48]. CONCLUSION: The modified HELP effectively reduced delirium rates in geriatric hospitalized patients. TRIAL REGISTRATION: This study was registered at the Iranian Registry of Clinical Trials IRCT20180910040995N1 .

Virulence genes in biofilm producer Enterococcus faecalis isolates from root canal infections.

Enterococcus faecalis is occurring in opportunistic infections involving the oral cavity. This study aimed to evaluate the presence of E. faecalis virulence genes in dental root canal isolates recovered from advanced chronic periodontitis patients. One hundred E. faecalis isolated from dental root canal during July 2015 to Oct 2016. After analysis of biofilm formation by the semi-quantitative determination in 96-well flat bottom polystyrene plates, the presence of asa, esp, efaA, ace, ebpR, gel and hyl gene were studied by PCR. Gelatinase and hemolytic activity were detected by phenotypic methods. Ninety-one percent of isolates had ebpR gene, 85% ace, 82% efaA, 81% gel, 56% esp, 33% asa1, 2% hyl and 0% cyl gene. Evaluation of biofilm formation by microtiter plate method presented 49% of the isolates as strong biofilm producer, 42% displayed moderate biofilm formation, and 10 % weak or no biofilm was observed. asa1, efaA, esp, and ebpR positive isolates had significantly higher biofilm formation than negative isolates, while no significant differences were found when comparing ace-positive and - negative isolates. Present study showed that the ace genes do not seem to be necessary nor sufficient for the production of biofilm in Enterococcus faecalis but the presence of asa1, efaA, esp, and ebpR correlates with increased biofilm formation of dental root canal isolates.

Marital satisfaction and adherence to religion.

Background: One of the most important determinants of health and marital satisfaction, the family and religious adherence can be effective because religion includes guidelines for life and providing a system of beliefs and values make these features can affect family life. Approach: This descriptive research - an analysis performed to assess the level of satisfaction of 47 questionnaires marital satisfaction questionnaire whose validity and reliability were evaluated and a couple of them asked to assess adherence to religion. The study population included 382 couples in Tehran that a cluster of 22 districts of Tehran were the selected. To analyze the data, ANOVA, Chi-square, and Pearson correlation coefficient using the software SPSS (version 22) became all tests were performed at the 5% level. Results: The data showed that the average age is 34 for women and 38 years for men and the majority of couples are in appropriate level in religiosity (40.5 percent). The results showed a main direct relation among religiosity and marital satisfaction of men and women (p ≤ 0.001). The correlation among religiosity and marital satisfaction of women r = 0.271 and this factor in men r = 0.200 was obtained indicating a direct relationship was significant. Conclusion: couples who were both committed to religion, their marital satisfaction score was more than couples without adherence to religion, and thus promoting religious beliefs and commitment can increase their marital satisfaction in couples.

Comparison of depression, anxiety, quality of life, vitality and mental health between premenopausal and postmenopausal women.

OBJECTIVE: The purpose of this research was to investigate and compare the rates of depression, anxiety, quality of life, vitality and mental health between premenopausal and postmenopausal women. METHOD: The sample included 218 women selected randomly from the cultural center of Tehran in November and December 2013 and was divided into two groups. The first group included 110 postmenopausal women (45-55 years old). One year had passed since their last monthly period and they had not used any hormones. The second group included 108 premenopausal women (35-45 years old) who had not yet experienced menopause. In order to assess data, three tests were used: the Zung Anxiety Self-Report scale, the Beck Depression Inventory and the Quality of Life questionnaire (SF-36). The gathered data were analyzed with the T-test for independent groups. RESULTS: The results indicated that all five hypotheses were confirmed. There were significant differences between the scores of anxiety, depression, quality of life, vitality and mental health between the two groups. CONCLUSION: Since menopausal women spend almost one-third of their long life in this situation, it can be useful to recognize the causes of these disorders in women and their influences on their families. We can also increase their motivation and self-efficacy in order to improve their quality of life.

Effects of Papaver rhoeas (L.) extract on formalin-induced pain and inflammation in mice.

Stress amelioration can improve its metabolic as well as other side effects. In the present study, the effects of hydro-alcoholic extract of Papver rhoeas (L.) on formalin-induced pain and inflammation were investigated in male Swiss-Webster mice (20-25 g). Formalin injects in the plantar portion of mice hind paw and pain was studied for 60 min. The plant extract and other drugs were administered intraperitoneally 30 min before formalin. Experiments showed that administration of extract (25, 50 and 100 mg kg(-1)) could induced analgesia in a dose-response manner in both phases of formalin test. More over, the extract inhibits inflammation induced by formalin injection. Naloxone (4 mg kg(-1)), dextromethorphan (20 mg kg(-1)) and NG-nitro-L-arginine-methylester (L-NAME; 10 mg kg(-1)) reduced the extract analgesia in first but not late phase. Extract administration also increased plasma corticosterone level in dose-dependent manner. It could be concluded that Papaver rhoeas (L.) extract could inhibits acute phase of formalin test in mice by opioidergic, glutamatergic and nitricergic mechanisms. In addition, the extract can induce corticosterone plasma level which may be responsible for inhibition of inflammation and chronic phase of pain induced by formalin.

Socio-economic and medical determinants of low birth weight in Iran: 20 years after establishment of a primary healthcare network.

OBJECTIVE: Establishment of a primary healthcare network in Iran has provided free and universal access to primary health care. Although the health status of Iranians has improved since this network was established, the low-birthweight rate has not decreased. The objective of the present study was to describe socio-economic and medical factors related to low birth weight in the context of free and universal access to primary health care. DESIGN: Descriptive, hospital-based prospective study. METHODS: Data about socio-economic, reproductive and prenatal condition of 4510 live singleton births from June to October 2004 were gathered using a standard questionnaire by interview and record review. The effect of these conditions on birth weight was investigated using a logistic regression model. RESULTS: Of 4510 newborns, 305 (6.8%) were low birth weight. Among these low-birthweight newborns, there were 159 preterm and 146 term newborns. Mothers with a primary and secondary education [odds ratio (OR) 6.83, 95% confidence interval (CI) 2.35-7.34 and OR 4.81, 95%CI 1.95-6.37, respectively], who lived with farmer and unskilled worker husbands (OR 2.52, 95%CI 1.12-4.66 and OR 2.91, 95%CI 1.35-2.52, respectively), with a birth interval of 1 year or less (OR 3.54, 95%CI 1.80-5.95) and height less than 155cm (OR 1.82, 95%CI 1.12-3.31) were more likely to have low-birthweight infants. CONCLUSION: In the context of free and universal access to health care, it is recommended that policy makers should place more emphasis on education as it imparts knowledge and thus influences dietary habits and birth-spacing behaviour. This will lead to a better nutritional status, particularly in dealing with pregnancy, resulting in lower rates of low birth weight.

Does group prenatal care affect satisfaction and prenatal care utilization in Iranian pregnant women?

BACKGROUND: The need to provide high quality prenatal care services, which take account of women's views and specifically address their need for information, support and communication, has been advocated and group prenatal care, had been suggested as one of the ways to achieve this objective. The purpose of this study was to examine the impact of group versus individual prenatal care on satisfaction and prenatal care use. METHODS: This was a cluster-randomized controlled trial with the health center as the randomization unit that conducted in 2007. Satisfaction was measured through a standardized questionnaire, and the Kotelchuck Adequacy of Prenatal Care Utilization Index was used to measure prenatal care utilization. RESULTS: We recruited 678 women (group prenatal care, (N= 344) and individual prenatal care, (N=334) in the study. Women in group prenatal care model were more satisfied than women in individual prenatal care model in all areas evaluated, including information, communication, co-ordination and quality of care. Group care women were significantly more likely to have adequate prenatal care than individual care women were (OR=1.35 95% CI=1.26-1.44). CONCLUSIONS: Group prenatal care was associated with a significant improvement in client satisfaction and prenatal care utilization. This model of care has implications for the planning and provision of prenatal services within public health system, which is moving toward a better quality health care, and increasing use of services.

Prevalence and associated factors of persistent diarrhoea in Iranian children admitted to a paediatric hospital.

To identify the frequency and associated factors of persistent diarrhoea in a paediatric hospital in Tehran, Islamic Republic of Iran, children admitted with acute diarrhoea were followed prospectively until resolution of the episode. Persistent diarrhoea developed in 19.6% of the 424 diarrhoea cases. Children with persistent diarrhoea were significantly younger than those with acute diarrhoea (15.3 versus 29.4 months). Enteroaggregative Escherichia coli was the most prevalent pathogen in both groups, but otherwise the profile of symptoms and isolated organisms was similar in the 2 groups. History of dietary change prior to admission and use of antibiotics and anticholinergic drugs in the acute phase were significantly higher in the persistent than acute diarrhoea cases.

Prevalence and associated factors of persistent diarrhoea in Iranian children admitted to a paediatric hospital

To identify the frequency and associated factors of persistent diarrhoea in a paediatric hospital in Tehran, Islamic Republic of Iran, children admitted with acute diarrhoea were followed prospectively until resolution of the episode. Persistent diarrhoea developed in 19.6% of the 424 diarrhoea cases. Children with persistent diarrhoea were significantly younger than those with acute diarrhoea [15.3 versus 29.4 months]. Enteroaggregative Escherichia coli was the most prevalent pathogen in both groups, but otherwise the profile of symptoms and isolated organisms was similar in the 2 groups. History of dietary change prior to admission and use of antibiotics and anticholinergic drugs in the acute phase were significantly higher in the persistent than acute diarrhoea cases

Determination of Helicobacter pylori virulence by analysis of the cag pathogenicity island isolated from Iranian patients.

BACKGROUND: The cag pathogenicity island (PAI), which can be divided into two parts, cagI and cagII, is the most well-known virulence factor of Helicobacter pylori. AIMS: We investigated the association between genetic variations within the cag PAI (cagA and cagE in the cagI and cagT in the cagII) and clinical outcomes in Iranian patients. SUBJECTS: A total of 231 patients including 182 patients with gastritis, 41 with peptic ulcer and 8 with gastric cancer. METHODS: The presence of the cagA, cagE and cagT genes were measured by polymerase chain reaction and the results were compared with clinical outcomes and gastric histology. RESULTS: The cagA, cagE and cagT genes were found in 154 (66.7%), 90 (39.0%) and 70 (30.3%) of clinical isolates. At least 144 (62.3%) strains possessed partially deleted cag PAI (e.g., 69 [29.9%] strains were cagA-positive, but cagE and cagT-negative). CONCLUSION: The single genes as well as the combination of genes in the cag PAI appeared not to be useful markers to predict H. pylori-related diseases in Iranian patients. The genomic sequences of the cag PAI in Iranian strains might be considerably different from those in other geographic locations.

Diagnosis and prevalence of enteropathogenic bacteria in children less than 5 years of age with acute diarrhea in Tehran children's hospitals.

INTRODUCTION: Acute diarrhea disease is the second cause of death among all infectious diseases in children younger than 5 years of age worldwide. The aim of this study was to employ a combination of biochemical, microbiological and molecular diagnostic techniques to investigate the stools of Iranian children with acute diarrhea for bacterial enteropathogens. METHOD: Diarrheagenic Escherichia coli, Shigella spp., Salmonella spp., Campylobacter spp. and Yersinia spp., were investigated from June 2003 to June 2005, in 1087 children less than 5 years old with acute diarrhea. Stool specimens from children were studied for enteropathogens both by standard culturing and molecular methods. This study was designed on hospital based. RESULT: The highest incidence values were found in the summer and in children less than 1-year-old (42.7%). The Pathogenic bacteria recovered out from fecal samples of 555 (55.1%) patients had the following profile: Shigella spp. (26.7%) was the most prevalent bacterial pathogen and Shiga-like toxin producing E. coli (STEC) and Enteroaggregative E. coli (EAEC) 105 (18.9%) and 92 (16.6%) had the second and third highest prevalence, respectively. Enteropathogenic E. coli (EPEC), Campylobacter, Salmonella and Enterotoxigenic E. coli (ETEC) were found in 70 (12.6%), 60 (10.8%), 42 (7.6%), and 38 (6.8%) positive samples, respectively. In this study neither Yersinia nor E. coli O157:H7 were found. Of the 30 co-infections detected, Shigella flexneri and Campylobacter jejuni accounted for more than 50%. CONCLUSION: Information about the prevalence of wide-range Shigella and STEC may facilitate the control and management of infant diarrhea diseases in Iran. The results of this study suggest that comprehensive surveys are needed in different parts of the country in order to identify the incidence of different enteropathogenic diarrhea, especially diarrheagenic E. coli in children in Iran.

Densitometric evaluation of skull and jaw bones after administration of thyroid hormones in rats.

OBJECTIVES: An investigation was performed by use of optical densitometry to observe the effects of different doses of thyroid hormone on bone density of skull and jaw bones and to evaluate the relationship between T3, T4, thyroid stimulating hormone (TSH) serum levels and bone density. METHODS: 40 Sprague-Dawley rats were randomly divided into four groups with 10 rats in each (a control group that received 10 ml kg(-1) i.p. per day normal saline and three levothyroxine groups that received 5, 10, or 20 microg kg(-1) i.p. per day levothyroxine, respectively). Radiographs were taken of their skulls on days 3 and 16. At the end of the experimental period blood was drawn by intracardiac puncture and serum was analysed for thyroid hormones (T3 and T4) and TSH level. After that, optical density measurements were made on the radiographs of four selected points on the skull and jaw with a digital densitometer. Density measurements were analysed using the student's t-test, one way analysis of variance, Spearman correlation analysis and regression analysis. RESULTS: Levothyroxine administration reduced bone density (P < or = 0.05) and increasing the dose of thyroid hormone produced a significant decrease of bone density (P < or = 0.05). The mandible was more susceptible to density changes compared with hard palate, skull and alveolar bone (P < or = 0.05). CONCLUSIONS: Radiographs of the mandible can be utilized to characterize loss of bone density elsewhere. In addition this investigation indicated that optical densitometry is an inexpensive and low risk method for studying bone density.

Differentiation of hepatic cavernous hemangioma from metastases by rare sequence MR imaging.

In this study, in order to differentiate cavernous hemangioma and hepatic metastases, rapid acquisition relaxation enhanced (RARE) sequence was used. First, in vivo measurements of T1, T2 relaxation times and proton density were obtained using T1, T2 calculation protocol (TOMIKON S50, 0.5T) and multipoint techniques. These measurements were made from regions of interest placed over the liver, spleen (because of similarity of relaxation time values between hepatic metastases and spleen) and cavernous hemangioma (HCH). Based on these intrinsic parameters, T2 curves signal intensity of three different tissues were constructed. At TE = 500 ms, the signal intensity of the liver and spleen has been near zero whereas in HCH, the signal intensity remained. As RARE sequence is very similar to spin echo (SE), by replacing effective TE(ETE) = 500 ms in the RARE equation, two dimensional contrast-to-noise ratio (CNR) contour plots were constructed demonstrating signal intensity contrast between liver-spleen, liver-Hemangioma for two different scan times (3 min, 7.5 s) and pulse timing. Then, optimal RARE factor and inter echo times were obtained in order to have maximum CNR between liver-Hemangioma and minimum CNR between liver-spleen. These optimal parameters were performed on ten normal and five persons with known HCH. Images showed that in both scan times (3 min, 7.5 s); the liver and spleen were suppressed whereas the HCH was enhanced. The image quality in the scan time of 3 min was better than the scan time of 7.5 s. Moreover, in this study, two different sequences were compared: i) Multi-slice single echo (MSSE) for T1 weighted image ii) RARE (ETE = 80 ms) for T2-weighted image. This comparison was done to show maximum CNR between liver-spleen (metastases) and to choose a better sequence for detecting metastases. CNR in the RARE sequence was more than in the MSSE sequence.

The effect of thyroid hormone on orthodontic tooth movement in rats.

The major goals of this study were to determine the effects of different doses of thyroxin on the rate of orthodontic tooth movement and the force-induced root resorption. In this study fifty male Sprague--Dawley rats were divided into five groups: a normal group with no intervention; a control group in which appliances were placed and 10 ml/kg i.p./day normal saline was injected; and three thyroxin groups in which appliances were placed and 5, 10 and 20/microgram/kg i.p./day L-thyroxin were administered, respectively. A fixed orthodontic appliance consisting of a 5 mm closed-coil spring was ligated between the maxillary incisor and maxillary first molar to deliver an initial force of 60 gm. The results showed that administration of 20/microgram/kg i.p./day L-thyroxin significantly increased the amount of orthodontic tooth movement (p < 0.001). The extent of root resorption as seen from scanning electron micrographs decreased with thyroxin administration.

Thermal modeling in cylindrical coordinates using effective conductivity.

Predictive thermometry, utilizing minimally invasive sampling techniques, is an essential ingredient in the development of hyperthermia treatment planning capabilities. The authors demonstrate a powerful, but simple approach toward predicting temperature distributions in tissues, based on analytic solution, using in cylindrical symmetry, of the heat diffusion equation. Conduction and localized perfusion effects are combined as an effective conductivity term, readily measurable, and parametrized in a general exponential form. The proposed approach allows a first-order approximation to modeling three typical situations: hypoxic or necrotic tumor core with homogeneously perfused periphery; highly perfused periphery (in rapidly growing tumors); or perfused central cover with a less well-supplied periphery (such as for some invasive tumors). The utility and strength of this approach is that it provides a rapid, accurate model of directly observing the technical quality to be expected for different heating methods, making it possible to optimally configure source distributions in a treatment planning setting.