Differences between living and deceased donation in human uterus transplantation: A narrative review.

The decision to use a living or deceased donor to perform uterus transplantation (UTx) is an evaluation of benefit and harm and is based on the medical team's choices. The current study determines the differences between living and deceased donation in human UTx according to determinant factors in choosing the donor type. For this review study, the PubMed database was searched without time, language, and location limitations up to May 2022. From 113 identified articles, 45 papers were included in the study for review. According to the results, in comparison to living donation, the biggest advantage of deceased donation is the lack of surgical and or psychological risks for the donor. In contrast, a comprehensive pre-transplantation medical assessment is less possible in deceased donation, and preplanned surgery cannot be realized. According to published peer-reviewed clinical trials on UTx, the graft failure rates in living and deceased donor UTx are 21% and 36%, respectively. Supposing all recipients who did not have graft failure underwent embryo transfer, live birth rates in living and deceased donor UTx procedures are almost 63% and 71%, respectively. Currently, considering the occurrence of live births from both donations, particularly from nulliparous deceased donor, increased demand for UTx in the near future, shortage of uterus grafts, and lack of sufficient data for a comprehensive comparison between the 2 types of donation, the use of both donations still seems necessary and rational.

The Development and Psychometric Assessment of a Coping Inventory for Intimate Partner Violence Among Abused Iranian Women.

Helping abused Iranian women better cope with intimate partner violence (IPV) requires measuring their coping strategies. The review of literature on the subject showed that there is no context-based instrument for measuring coping with IPV among abused Iranian women. The present study was thus conducted to develop and perform the psychometric assessment of a coping inventory for intimate partner violence (CIIPV) in abused Iranian women.In this methodological study, two consecutive studies were carried out for the development and psychometric assessment of CIIPV. In the first study, the inventory items were designed based on the results of a previous qualitative study that was conducted to identify the coping strategies used for IPV among abused Iranian women. In the second study, the inventory's validity and reliability were examined. The face validity, content validity, construct validity, and convergent validity of the inventory were also evaluated. Moreover, to assess the reliability of the inventory, its internal consistency was estimated using Cronbach's alpha coefficient.A total of 58 items were designed in the first study and then psychometrically assessed. The final version of the inventory comprised 29 items and 6 factors, including negotiation, instrumental action, help-seeking, positive cognitive restructuring, spiritual support-seeking, and distraction. The content validity index of the entire inventory was 1. The extracted factors explained 75.44% of the variance. The convergent validity of the CIIPV was confirmed with a medium positive relationship between the conceptually similar subscales in the two instruments CIIPV and the Ways of Coping Questionnaire. Furthermore, the Cronbach's alpha coefficient of the entire inventory was 0.86, indicating its suitable reliability. Given the results, the CIIPV is a valid and reliable domain-specific tool to measure the coping strategies used for IPV among abused Iranian women.

Dynamics of host immune responses to SARS-CoV-2.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the most recent global health threat, is spreading throughout the world with worrisome speed, and the current wave of coronavirus disease 2019 (COVID-19) seems to have no mercy. While this mysterious virus challenges our ability to control viral infections, our opportunities to control the COVID-19 pandemic are gradually fading. Currently, pandemic management relies on preventive interventions. Although prevention is a good strategy to mitigate SARS-CoV-2 transmission, it still cannot be considered an absolute solution to eliminate this pandemic. Currently, developing a potent immunity against this viral infection seems to be the most promising strategy to drive down this ongoing global tragedy. However, with the emergence of new challenges in the context of immune responses to COVID-19, the road to control this devastating pandemic seems bumpier; thus, it is pivotal to characterize the dynamics of host immune responses to COVID-19, in order to develop efficient prophylactic and therapeutic tools. This begs the question of whether the effector mechanisms of the immune system are indeed potent or a possible contributing factor to developing more severe and lethal forms of COVID-19. In this review, the possible role of the immunopathologic phenomena including antibody-dependent enhancement, cytokine storm, and original antigenic sin in severity and mortality of COVID-19 will be discussed.

Barriers to Leaving a Relationship From the Perspective of Married Abused Iranian Women: Secondary Analysis of the Interviews With Abused Women.

Violence has a heavy impact on the physical and mental health of women in developed and developing countries; however, most of the violence victims would suffer in silence and never leave their relationship. The aim of the present study was to identify the barriers to leaving a relationship from the perspective of married abused Iranian women. The present study was a secondary analysis of the interviews conducted in a primary study. The primary study that was conducted using the grounded theory approach has assessed the coping process with domestic violence in 24 married abused Iranian women. These women were selected from local parks, health centers, and universities of Tehran city using a purposive sampling method. Qualitative secondary analysis of the interviews was conducted, in accordance with the goal of this study, using content analysis. Four categories emerged through the analysis of the data including "fear," "lack of resources," "beliefs and attitudes," and "dependence" and the common theme between these categories was "deterrents to leaving an abusive relationship." Results indicated that contextual factors such as fear, lack of resources, attitudes and beliefs, and dependence were the reason for not leaving a relationship. Interventions for enriching women's resources (improving the condition of education and employment, and improvement of the formal and informal support systems), education about domestic violence and its management methods, and modification of the existing attitudes and beliefs in this regard could keep abused women from experiencing more violence.

Hepatitis E Virus Infection During Pregnancy: The Overlooked Cause of Maternal and Fetal Mortality.

BACKGROUND: Hepatitis E virus (HEV) is one the leading causes of maternal and fetal mortality. Nevertheless, in some geographical locations, especially Egypt, despite having high frequency of HEV seropositivity, HEV infection follows an asymptomatic or mild course during pregnancy. These anomalous observations have distracted attention from the importance of HEV infection in pregnant women. METHODS: While tragic cases of HEV-infected pregnant women cannot be neglected any longer. CONCLUSION: These circumstances create a strong demand for the increasing awareness of HEV infection through training programs, appropriate management of HEV infection among pregnant women, routine screening of pregnant women for timely diagnosis of HEV infection, proper treatment of HEVinfected patients, optimal preventive measures, and development of a prophylactic vaccine against HEV infection.

Prevalence, risk factors and molecular evaluation of hepatitis E virus infection among pregnant women resident in the northern shores of Persian Gulf, Iran.

BACKGROUND: Although Iran is reported to be an endemic country for hepatitis E virus (HEV), data on the prevalence of HEV infection among pregnant women are scarce and the epidemiology of HEV is unknown in most parts of the country. Therefore, this study was conducted to elucidate the prevalence, risk factors and genotypic pattern of HEV infection among pregnant women resident in the northern shores of Persian Gulf. This is the first report on the epidemiology of HEV infection among pregnant women in this territory. METHODS: From October 2016 to May 2017, 1331 pregnant women participated in this study. The mean age ± SD of participants was 27.93±5.7 years with a range of 14-45 years. Serum samples of pregnant women were screened for the presence of anti-HEV total antibodies, anti-HEV IgG and anti-HEV IgM using commercially available ELISA kits (DIA.PRO, Milan, Italy). All anti-HEV IgG and anti-HEV IgM positive samples were tested for HEV RNA using two independent reverse transcriptase polymerase chain reaction (RT-PCR) assays, targeting ORF2 and ORF3 of HEV genome. In addition, 92 anti-HEV seronegative samples as well as 50 pooled seronegative samples were evaluated by two independent RT-PCR assays for validation of results. RESULTS: Of the 1331 pregnant women, 84 women (6.3%, 95% CI: 5.1%-7.7%) were positive for anti-HEV antibodies, of which 83 women had anti-HEV IgG, and 11 women (0.83%, 95% CI: 0.47%-1.47%) had anti-HEV IgM. The highest rate of HEV seroprevalence was observed among Afghan immigrants (68.0%), uneducated pregnant women (46.51%) and those residents in Bushehr city (8.75%). All anti-HEV IgG and/or IgM positive samples were found to be negative for HEV RNA. In addition, all of the evaluated anti-HEV seronegative samples were negative for HEV RNA. HEV seropositivity among pregnant women was statistically associated with age, ethnicity, place of residence, number of pregnancies, and level of education. So that, low education levels, Afghan, residence in Bushehr city, age group >34 years, and more parities were risk factors for exposure to HEV. In contrast, HEV seropositivity was not associated with stage of gestation, history of abortion, and time of sampling. CONCLUSION: The northern shores of Persian Gulf in Iran, with HEV seroprevalence of 6.3%, can be classified as an endemic geographical region for hepatitis E, and residents of Bushehr city, Afghan immigrants and uneducated women are the main at-risk populations in this territory.

Prevalence and Trends of Transfusion-Transmissible Viral Infections among Blood Donors in South of Iran: An Eleven-Year Retrospective Study.

BACKGROUND: Blood transfusion is considered a potential risk factor for transmission of life-threatening viral infections, including HIV, HCV and HBV infections. This study was performed to find out the prevalence and trends of these infections among blood donors in Southern Iran. METHODS: The blood donor data recorded in twelve regional blood transfusion centers from 2004 to 2014 were analyzed in an anonymous way with respect to the results of serological screening for HBV, HCV, and HIV infections. Overall, 293454 donors were screened for viral infections. RESULTS: Most of the donors were male, married, aged between 20-40 years, educated, and regular donors. The overall seroprevalence rates of HBV, HCV and HIV were 0.15%, 0.1% and 0.004%, respectively. The highest seroprevalence was found for HBV, followed by HCV and HIV. These infections were more prevalent in male, low educated and first time donors. The highest HCV seroprevalence was observed among donors aged 20 to 40 years, while HBV seroprevalence increased with age. The seroprevalence rates of HBV and HCV from 2004 to 2014 showed significant decreasing trends from 0.460% to 0.060% (P < 0.001) and 0.329% to 0.045% (P < 0.001), respectively. Whereas HIV infection had a slight but not significant decline from 0.0173% in 2004 to 0.0028% in 2014 (P = 0.087). CONCLUSIONS: The decreasing trends of transfusion-transmissible viral infections in blood donations indicate that the attempts of IBTO were successful in improving the safety of the blood supply, since the prevalence rates of viral infections have been reduced to very low levels in blood donations over the years. However, still more effective techniques such as polymerase chain reaction (PCR) are needed to guarantee blood safety.

Iranian Women's Experiences with Intimate Partner Violence: A Qualitative Study.

BACKGROUND: Violence against women has been identified as a public health problem, which has fundamental consequences on women's physical, mental, and reproductive health. To understand abused women and provide support for them, it is necessary to enter the world in which the victims of intimate partner violence live. This study was designed to investigate experiences of abused Iranian women of intimate partner violence. METHODS: Content analysis approach was used to design this qualitative study. Participants were 11 married women, selected from two health centers and one park located in the south of Tehran, Iran. Purposive sampling method was applied to recruit the study participants and continued until data saturation was reached. Semi-structured interviews were employed to collect data. RESULTS: During the data analysis, 650 initial codes were clustered in six subcategories and two categories. "Neglect or covert violence" and "overt violence" were two categories emerged through data analysis, both having physical, sexual, and emotional dimensions. Emotional violence was the most prevalent in both cases and had more significance for the women. Neglect was much more common than overt violence. It was the precursor for overt violence. CONCLUSION: Although participants had experienced both neglect and overt violence, the major part of experienced violence was neglect. This type of violence usually is not addressed or recognized and is difficult to identify, but it is damaging to women. Knowledge of women?s experiences of intimate partner violence makes the health staff provide better care for abused women.