Background. Anxiety is more common during pregnancy than in any other periods. Thus, medical problems such as diabetes can increase the anxiety of pregnant women. Objectives. The main objective of this study was to investigate the effectiveness of mindfulness-based training on anxiety in pregnant women with gestational diabetes. Materials and methods. This study was a randomized controlled trial study with a pre-test, post-test and control group. Among 24-28 week pregnant women with diabetes who referred to health centers in Kerman, 88 women were selected. Participants were randomly allocated into intervention and control groups. Mindfulness-based training was used for the intervention group over 8 weeks, and situational and trait anxiety was measured through a Spielberg anxiety questionnaire. The collected data was analyzed using SPSS version 22 software. Results. There was no significant difference between the mean scores of situational and trait anxiety before intervention in both the intervention and control groups (p = 0.159, p = 0.21). However, mean situational and trait anxiety decreased in the intervention group and increased in the control group after intervention/treatment. There was significant increase over time. The difference between the two groups was also significant during the intervention and post-intervention periods (p-value < 0.0001). Conclusions. Mindfulness-based counseling conducted by a midwife decreased the anxiety of pregnant women with gestational diabetes.

Background:Lead effects on children and pregnant women are grave, and screening tests would be logical to detect high blood lead levels (BLLs) in early stages.Materials and Methods:Blood samples were taken from the pregnant mothers who referred to midwifery clinic with further phone interview postdelivery.Results:In 100 patients evaluated, the mean age was 29 ± 5 years (median interquartile range gestational age of 33 [24, 37] weeks). There was a significant correlation between polluted residential area and median BLL (P = 0.044) and substance exposure (P = 0.02). The median BLL was significantly lower in those without a history of lead toxicity in the family (P = 0.003). The only factor that could predict the BLL levels lower than 3.2 and 5 μg/dL was living in the nonindustrial area. All pregnant women delivered full-term live babies.Conclusion:Positive history of lead toxicity in the family and living in polluted areas may pose a higher BLL in pregnant women.

Objective: The detection of pulmonary embolism in emergency department requires an urgent therapeutic and diagnostic attention. This study was performed to determine the accuracy and efficacy of ultrasound in the diagnosis of pulmonary embolism. Methods: In this study, 110 patients who referred to the emergency department with traumatic embolism symptoms were enrolled. All the patients underwent computed tomography (CT) angiography. Patients were divided into positive and negative outcomes according to the results of transthoracic ultrasonography and CT angiography. Results: In this study, 110 patients were enrolled, of whom 52 (47.3%) were male and 58 (52.7%) were female. Among the patients, 100 (90.9%) patients presented with dyspnea, whereas the frequency of pleural pain was 27% (24.5%). Sensitivity, specificity, positive predictive value, and negative predictive value for ultrasound were 45.67%, 77.41%, 88.09%, and 35.29%, respectively. The positive outcomes from CT scan were significantly associated with gender, p = 0.005. The gender and transthoracic ultrasonography outcomes were also significantly correlated, p = 0.019, and the outcomes of ultrasound were significantly different from those of CT scan, p = 0.008. Conclusion:Transthoracic ultrasonography may be used to diagnose pulmonary embolism as a technique in the emergency department, especially in patients who are unable to move due to the severity of the disease. However, further comparative studies are required in this aspect.

PurposeInfective endocarditis (IE) remains a disease with high morbidity and mortality. The aim of this study was to determine the clinical characteristics and echocardiographic features of patients with IE.MethodsWe analyzed patients with either definitive or probable diagnosis of IE who were hospitalized in a teaching hospital in Mashhad, Iran between June 2011 and January 2020. Patients who survived were followed up by echocardiography for at least 6-month after hospital discharge.ResultsA total of 82 cases with IE were included of which 62 (75.6%) received definitive diagnosis. The mean age was 39.7 ± 18.7 years and 52 (63.4%) were male. The most common preexisting structural cardiac abnormality that predispose patients to IE were congenital heart diseases (28 %) of which bicuspid aortic valve was more common (n = 12, 14.6%), followed by ventricular septal defect (n = 9, 11%) and Tetralogy of Fallot (TOF) (n = 2, 2.4%). Three (3.6 %) cases had rheumatic heart disease and 12 (14.6 %) were injecting drug users. The most common causative pathogen was Staphylococcus aureus, detected in 7 (19.4%) cases. Follow-up echocardiography revealed right or left ventricular failure in 10 (12.1%) cases. Cardiac complications occurred in 41 (50%) cases and systemic complications in 63 (76.8%). All-cause mortality was 41.5% (n = 34) and 6 (18.1%) patients died due to cardiovascular complications.ConclusionsThe short- and long-term prognosis in IE was poor and the predictors for in-hospital and 1-year mortality were defined as heart failure and septic shock. Congenital heart disease and intravenous illicit drug using (IVDU) were the most common predisposing condition which may necessitate a revision in the IE prophylaxis recommendations.