Predictor Factors of Female Sexual Distress in a Population-Based Sample of Iranian Women: a Path Analysis.

PURPOSE: To investigate the direct and indirect effects of demographic characteristics, relationship satisfaction, and psychological factors on female sexual distress (FSD) using path analysis. MATERIALS AND METHODS: This study was conducted in two stages. Initially we obtained the FSD predictor factor's conceptual model through a literature review and expert panel. In the Second stage, a population-based cross-sectional study on 207 non-pregnant and married women (without any age restriction) in Zanjan, Iran was conducted. FSDs-R, FSFI-6, DASS-21, and GEMREL Standard questionnaires and the demographic researcher-made questionnaire were used in this study. The data undergone path analysis based on the initial conceptual model. RESULTS: Sexual function (SF) had the strongest relationship with FSD from the direct path (ß = -.49) and overall effect (ß = -.58). The highest indirect effect belonged to depression-anxiety-stress level (ß = .284) mediated by SF (ß = -.42) and relationships satisfaction with spouse (ß = -.20). Age difference (ß = -.13) and relationships satisfaction with spouse (ß = -.19) had only a direct effect on FSD. Marriage Duration had only indirect effect on FSD through mediating role on SF (ß = -.26) and depression-anxiety-stress level (ß = -.15). CONCLUSION:  Among the predictor factors investigated in this study, sexual dysfunction is the most important predictor of FSD. In addition; men older than their spouses, longer marriage duration, relationship dissatisfaction with the spouse and higher rate of depression-anxiety-stress have positive correlation with SD. Therefore, we should offer a combination of the mentioned factors in providing care for women with SD.

Cytotoxicity and Anti-Plasmodium berghei Activity of Emodin Loaded Nanoemulsion.

Background: Malaria parasites cause a tremendous burden of disease in both the tropics and subtropics areas. Growing of drugs resistance in parasites is one of the most threats to malaria control. The aim of study was to investigate the anti-malarial activity of nano-emodin isolated from Rhamnus cathartica on Plasmodium berghei in mice to evaluate parasites inhibition rate using in-vivo test. Methods: The study was conducted in the School of Public Health, Tehran University of Medical Sciences, during 2020. Nano-emodin particles were prepared from Rhamnus cathartica, and confirmed by Zeta Potential Analyzer, DLS and electron microscopy techniques. Mice were infected with P. berghei and treated by emodin nano-particles. Parasitemia was evaluated in each group in comparison with control group. Toxicity test was done using twice the highest concentration of emodin extract on a separate group of mice and ED50 was calculated. Results: Emodin extract was significantly effective in all concentrations on D4 (P<0.05). The most effective on parasitemia was observed in 400 mg/kg of Liquid Nano-emodin and solid (non-Nano) emodin. ED50 for emodin extract was determined 220 mg/kg. Toxicity test showed no toxic effect on the subjects. Conclusion: The emodin extract is safe, lack of side effects. So, it can be used for more and longer period of time and in higher doses. Emodin extract, either in form of liquid and nanoparticle or in a solid form, has the same therapeutic effect on P. berghei in infected Balb/c mice.

Human Toxocariasis in individuals with blood disorders and cancer patients: the first seroepidemiological study in Iran.

Toxocara is one of the most prevalent nematodes in Iran, which infect humans as an intermediate host. Infection complications result from the larva migration. Human toxocariasis prevalence was various in Iran according to the area of study and population. This study was designed to evaluate the seropositivity of Toxocara IgG in patients with blood disorders and cancer patients in southwest Iran. Moreover, the study of the associated risk factors for this infection. A total of 1122 serum samples, from February 8, 2019 to August 21, 2019, including 600 healthy individuals and 522 individuals with cancer and blood disorders patients were collected. Serum samples were collected for detection of Toxocara IgG by using ELISA (Enzyme-Linked Immunosorbent Assay) kit. Sociodemographic data of all participants were collected and examined to determine their association with the infection. Out of 101 individuals with white blood cell disorders (5.94%), red blood cell disorders (7.48%) and cancer patients (11.06%) were seropositive for Toxocara IgG antibodies. The infection rate among all study population revealed that (10.76%) were positive for Toxocara IgG. This study showed the fundamental role of contact with pets and infection in groups with blood cell disorders (P-value ≤ 0.05%); while in cancer patients the association wasn't significant. Other factors such as age, location of residence, and sex showed that the association with this infection wasn't significant.

Characterization of Niemann-Pick diseases genes mutation spectrum in Iran and identification of a novel mutation in SMPD1 gene.

Background: Niemann-Pick diseases are rare inherited lipid storage disorders caused by mutations in the SMPD1, NPC1, and NPC2 genes. The aim of this study was to assess the mutation spectrum of a cohort of Iranian Niemann-Pick patients. Methods: A consanguineous couple with a child suspected of having Niemann-Pick disease type A (died at age 2) was screened for gene mutations in the SMPD1 gene. Sanger sequencing was performed for all exons and exon-intron boundary regions. A literature review on SMPD1, NPC1, and NPC2 genes mutations in Iran was conducted using published original papers on this subject. Results: A novel frameshift c.762delG (p.Leu256fs*) at a heterozygous state was identified in the parents. According to the review study, identified mutations in 39 Iranian patients were concentrated in exon 2 of the SMPD1 gene and exons 8 and 9 of the NPC1 gene. Conclusion: Niemann-Pick diseases genes mutation analysis (SMPD1, NPC1, and NPC2) in Iran shows the genetic heterogeneity of these diseases in this country. More studies with larger sample sizes should be conducted to further examine genetic changes associated with Niemann-Pick diseases in Iran.

Surgical outcome and clinicopathological characteristics of emergency presentation elective cases of colorectal cancer.

INTRODUCTION: The aim of this study was to evaluate the significance of clinicopathological characteristics of colorectal cancer patients undergoing emergency and elective surgery. MATERIAL AND METHODS: In total, 116 tumors from patients treated surgically for colorectal cancer at four hospitals in Tehran between 2008 and 2013 were analyzed in the current study. RESULTS: Our findings revealed that the emergency cases were significantly more likely to have an advanced TNM stage (p = 0.027) and histologic grade (p = 0.01) compared with the elective patients. Furthermore, the nature of surgery was significantly associated with vascular and perineural invasion (p = 0.021; p = 0.001). We also evaluated the association of gender, age, and tumor location with the nature of surgical presentation. However, no association was found between these parameters and the nature of surgery. Emergency was also correlated with greater length of hospital stay and higher rate of admission to the intensive care unit. The mortality rate was 20% in emergency cases, while patients with elective surgery had 5.63% perioperative mortality (p = 0.001). The emergency patients had a higher rate of mortality. CONCLUSIONS: Our data indicated that colorectal cancer patients undergoing emergency surgery showed an advanced stage. The emergency patients had a higher rate of mortality than elective cases.

The Relationship Between Blood Lead Level and Preeclampsia.

INTRODUCTION: Lead is a heavy metal to which people are commonly exposed. One of the possible mechanisms of tissue damages caused by this toxic metal is oxidative stress, which in turn may cause numerous pregnancy complications such as preeclampsia. The present study was conducted to determine the relationship between maternal Blood Lead Level (BLL) and preeclampsia. METHODS: The present case-control study was conducted on 158 pregnant women admitted to a hospital in Zanjan, Iran, from August 2015 to March 2016. To measure their BLL, 1.5 cc of blood was drawn from each participant. The demographic and obstetric details of the patients were recorded in a form. The potentiometric method was used to test the samples. The data obtained were analyzed by SPSS version 22, using Mann-Whitney U test, the Chi square, independent-samples t-test, Pearson product-moment correlation, and simple linear regression analysis. RESULTS: The mean BLL was 6.24±1.74 µg/dl in the control group and 8.04±3.4 µg/dl in the preeclampsia group. The two groups were matching in terms of the mother's age and education and the household income. A significant relationship was observed between BLL and preeclampsia (p=0.028), as per every unit of increase (1 µg/dl) in BLL, systolic blood pressure increased by 0.014 mm Hg and diastolic blood pressure by 0.013 mm Hg (p=0.004). CONCLUSION: The results obtained suggest a relationship between BLL and preeclampsia. Global health measures should be taken to remove the exposure to lead so as to reduce its absorption by pregnant women.

A study of the efficacy of furosemide as a prophylaxis of acute renal failure in coronary artery bypass grafting patients: A clinical trial.

BACKGROUND: Renal failure is a frequent event after coronary artery bypass grafting (CABG). Hemodynamic alterations during surgery as well as the underlying disease are the predisposing factors. We aimed to study intermittent furosemide therapy in the prevention of renal failure in patients undergoing CABG. METHODS: In a single-blind randomized controlled trial, 123 elective CABG patients, 18-75 years, entered the study. Clearance of creatinine, urea and water were measured. Patients were randomly assigned into three groups: furosemide in prime (0.3-0.4 mg/kg); intermittent furosemide during CABG (0.2 mg/kg, if there was a decrease in urinary excretion) and control (no furosemide). RESULTS: There was a significant change in serum urea, sodium and fluid balance in "intermittent furosemide" group; other variables did not change significantly before or after the operation. Post-operative fluid balance was significantly higher in "intermittent furosemide" group (2573 ± 205 ml) compared to control (1574.0 ± 155.0 ml) (P < 0.010); also, fluid balance was higher in "intermittent furosemide" group (2573 ± 205 ml) compared to "furosemide in prime" group (1935.0 ± 169.00 ml) (P < 0.010). CONCLUSION: The study demonstrated no benefit from intermittent furosemide in elective CABG compared to furosemide in prime volume or even placebo.

Gender differences in depression scores of Iranian and german medical students.

OBJECTIVE: The aim was to evaluate gender differences in depression scores of Iranian and German medical students. METHODS: Two hundred Iranian medical students (100 men and 100 women) and 200 German medical students (100 men and 100 women) were selected randomly and completed the English form of the self-rating Beck Depression Inventory (BDI). RESULTS: Analysis gave a mean rating of 10.7 ± 6.6 for Iranian men and 10.9 ± 7.81 for Iranian women (NS). Also, 5 ± 4.9 for German men and 5.6 ± 5.0 for German women (NS). On Item 2, which asked whether the person was pessimistic 33% of Iranian men and 30% of Iranian women indicated that they were pessimistic (NS). Also, 21% of German men and 20% of German women indicated that they were pessimistic (NS). On Item 9, which asked about suicidal tendencies, 9% of Iranian men and 13% of Iranian women reported as having suicidal tendencies (NS). Also, 13% of German men and 21% of German women reported as having self-harming thoughts (NS). CONCLUSION: The present study showed no gender differences in Iranian and German medical students' scores on the BDI.

Prenatal diagnosis of ß-thalassemia in twin pregnancies in Iran.

OBJECTIVE: Prenatal diagnosis of ß-thalassemia carrier couples has helped to prevent bearing affected children. Among 177 couples referred to our laboratory for prenatal diagnosis, 14 mothers had twin pregnancies.  METHODS: By using direct and indirect methods, we determined their mutations and linkage analysis using polymorphic markers (restriction fragment length polymorphism [RFLP]).  RESULTS:  It was shown that in five families both fetuses were heterozygote carriers. In another five families, one fetus was normal and the other one was carrier. In two families, one fetus was affected and the other one was heterozygous carrier; in one case one fetus was affected and the other one was homozygote normal. In the last family both fetuses were homozygote normal. If all fetuses were fraternal then one would expect to see seven homozygote normal and the same number affected, and 14 carriers. CONCLUSION: Our results indicated that at least in cases where both fetuses had identical genotypes, then they may be identical twins. Molecular testing indeed showed that in three cases the twins were identical. Another point is that in three cases, one of the twin fetuses was affected and the other one was either normal or heterozygote in which only the affected fetuses were aborted by the specialist.

Early hemodynamic changes after mitral valve replacement in patients with severe and mild pulmonary artery hypertension.

PURPOSE: to assess the early hemodynamic changes after elective mitral valve replacement (MVR) in patients with severe and mild pulmonary arterial hypertension (PAH). METHODS: a total of 45 consecutive patients, who were candidate for elective MVR, were enrolled in this prospective observational study. Patients were divided into two groups based on the absence (group A, 20 patients) or presence (group B, 25 patients) of severe pulmonary artery hypertension (PAH) defined as systolic pulmonary artery pressure ≥50 mmHg measuring by catheterization. MVR was performed using standard cardiopulmonary bypass (CBD) technique. The hemodynamic and arterial blood gas assessments were carried out at baseline before the induction of general anesthesia, in the operating room immediately after MVR, and then continued after stabilization of hemodynamic status with 2 hr interval up to 24 hours. RESULTS: The mean CPB and aortic cross-clamp times were similar in two groups (95.3 ± 49.5 and 61.8 ± 36.3 minutes in group A and 103.1 ± 34.7and 61.9 ± 20.0 minutes in group B). In group A, the mean PAP showed an increase immediately after the operation (from 40.4 ± 7.3 to 43.10 ± 6.2 mmHg) and then decreased significantly to 32.5 ± 3.9 mmHg (P <0.05). In group B, the mean PAP showed no significant reduction immediately after MVR, but it decreased significantly below the range of severe PAP over the first 24 hours. CONCLUSION: MVR is safe and effective even in patients with severe PAH. The anesthetic technique and postoperative cares can be useful in improving the outcome in such patients.

The effects of education based on extended health belief model in type 2 diabetic patients: a randomized controlled trial.

BACKGROUND: Type II diabetes and its complications impose a large economic burden on health care systems. This study aims to assess the effectiveness of educational intervention based on extended health belief model on type 2 diabetic patients. METHODS: 120 patients with type II diabetes referring to randomly selected hospitals of Tehran University of Medical Sciences were enrolled in this educational intervention study. Patients were randomly divided into two groups (intervention and control). Data were collected using a questionnaire including demographic information and extended health belief model constructs. Two face to face educational sessions were conducted for each patient. Data were collected in two groups at three stages of the study; before the educational sessions and at 3 months and 6 months intervals. Analysis was performed by SPSS (17.0) and STATA (11.0) using independent T-test, Chi-square, Fisher's exact test, analysis of covariance and Generalized Estimating Equation. A p value of less than 0.05 was regarded as statistically significant. RESULTS: The educational program had a positive and significant impact (p < 0.0001) on extended health model belief constructs (including perceived susceptibility, perceived intensity, perceived benefits, perceived barriers and self-efficacy) in experimental group, 3 and 6 months after the intervention. CONCLUSIONS: The results of this study showed the importance of extended health belief model based education in improving the model constructs and increasing self-efficacy in patients with type-2 diabetes.

Co-inheritance of hemoglobin D and ß-thalassemia traits in three Iranian families: clinical relevance.

Here we report the result of three cases referred to our lab that had a combination of ß-thalassemia and hemoglobin D (Hb D) traits. These individuals had no symptoms of profound anemia and hematological indices were similar to that of a ß-thalassemia heterozygote. In all three cases, the Hb D level was elevated and no HbA was detected electrophoretically. The electrophoresis pattern suggested that all cases were homozygotes for Hb D. PCR followed by digestion with EcoRI and sequencing of the ß-globin gene confirmed the presence of Cd 121 GAA>CAA in the heterozygous form with another ß-globin mutation. In all cases, the mutations in the ß-globin gene were detected by ARMS PCR technique and they were either IVSII-I or IVSI-5. Hematological studies of the family members showed that thalassemia which caused the mutations and Hb D were in the trans position.

A novel polymorphism causes a different restriction pattern by RsaI in the beta-globin gene cluster: application in prenatal diagnosis.

beta-Thalassemia (beta-thal) is a major health problem in Iran and the incidence of carriers is around 3-4%. The disease is caused by heterogeneous mutations in the beta-globin gene and is characterized by hypochromic microcytic anemia. The human beta-globin complex spans a region of 70 kb and contains over 20 restriction fragment length polymorphisms (RFLPs). At least nine RFLP markers including RsaI/beta in the beta-globin gene cluster have been routinely exploited for prenatal diagnosis. Here, we report a novel polymorphism upstream of the beta-globin gene characterized by RsaI digestion. Sequencing of a fragment containing this area showed a nucleotide change (T>C) at position -223 upstream of the beta-globin gene. This change could interfere with precise interpretation of the RsaI digestion pattern in linkage analysis and prenatal diagnosis of beta-thal.