SARS-CoV-2, the leading cause of COVID-19 pandemic, was detected for the first time in Wuhan. In this study, we investigated the potential undesirable maternal and feto-neonatal consequences of COVID-19, and the related pathophysiological alterations in mother, neonate, and especially in the placenta as a vital organ, were reviewed. Also, the possibility of vertical transmission of virus and placental abnormalities were evaluated. The pregnant women were a vulnerable population for COVID-19, and several obstetric consequences were reported following SARS-CoV-2 infection. The higher risk of abruption, preterm labor, maternal death, stillbirth, intrauterine growth restriction, and newborns with fetal distress were adverse pregnancy and perinatal outcomes of COVID-19. Despite the ACE2 expression on placental components was confirmed, there is no agreement on the mother–child vertical transmission of this virus. Therefore, feto-neonatal consequences might be associated with placental abnormalities. The placental abnormalities are characterized by feto-maternal vascular malperfusion. Additionally, these adverse consequences lead to early termination of pregnancy in some cases, mostly via cesarean section. The pregnant women screening, coordination between healthcare personnel and neonatal unit, and infected women quarantine may decrease the risk of maternal and neonatal death after delivery.

BackgroundThere is a considerable rate of fertility failure and this causes a great burden of untoward effects for patients. Usually a considerable number of these patients undergo anesthesia for their treatment.ObjectivesThis study was designed to compare the effects of general and spinal anesthesia on these patients.Patients and MethodsIn a randomized clinical trial, after taking informed written consent from the patients, 200 patients entered the study; 100 in each. During a 2 year period, women aged 20 to 40 years entered the study (one group receiving spinal anesthesia and the other, receiving general anesthesia). Ovum retrieval protocols were the same. Nonparametric and parametric analyses were used for data analysis. P value less than 0.05 was considered significant.ResultsThere was no difference between the two groups regarding demographic variables. 15 of 100 patients (15%) in the general anesthesia group and 27 of 100 patients (27%) in the spinal anesthesia group had successful pregnancy after IVF; so, spinal anesthesia increased significantly the chance of IVF success (P value < 0.001; Chi Square).ConclusionsThe results of this study demonstrated that spinal anesthesia increased the chance of fertilization success.

Double-J (DJ) stents are the main tools used in urological practice for prevention and treatment of obstruction. Stenting is also mandatory after complicated ureteroscopy or TUL (Transureteral Lithotripsy). Known complications are upper migration of DJ stents into the kidney and lower migration to the bladder. In a man with an impacted right lower ureteral stone, a DJ stent was placed because the ureteroscope was not passed from an intramural ureter. We reported a very rare complication of DJ ureteral stent placement with intravascular migration to the pulmonary arteries, which was removed percutaneously through the right femoral vein under fluoroscopic guidance.

Background: There is no doubt that problems during wakefulness can affect the quality and length of sleep. Sleep disturbances can have a serious negative effect on a person's ability, function, and overall well-being. One of the most important issues that can result in sleep disturbances is professional causes, and the most important of which is shift work. The present study aimed at investigating the association between shift work and various sleep disorders and quality of life. Methods: This was a cross-sectional study. The data were collected using the Persian version of Epworth sleepiness scale andSF-36 questionnaires to assess the participants' sleep disorder and quality of life. The questionnaires were filled in by 207 shift workers. Age, gender, shift works experience, and working experience were recorded for all participants.

Purpose The purpose of this paper is to introduce an integrated approach using failure modes and effects analysis (FMEA), multiple-criteria decision making (MCDM), mathematical modeling and quality function deployment (QFD) techniques, for risk assessment and service quality enhancement in coronary artery bypass grafting (CABG) as a treatment for cardiovascular diseases (CVDs). Design/methodology/approach First, the disruptions in the CABG process are identified and prioritized following FMEA instructions, using two MCDM techniques, called analytic hierarchy process (AHP) and TOPSIS. Consequently, several corrective activities are identified and weighted on the basis of QFD. Finally, a mathematical model is established to determine the most cost-effective activities for implementation. The approach is developed in a fuzzy environment to reflect the uncertainty and ambiguity of human reasoning. Findings Regarding the CABG process disruption, a total of 30 failure modes in four main categories were identified and prioritized. Moreover, eight corrective activities were devised and ranked according to their impact on the failure modes. Finally, considering a limited amount of budget, a sensitivity analysis on the mathematical model’s objective function indicated that using 30 percent of the total budget, required to implement all corrective activities, was enough to cover more than 70 percent of the effects of corrective activities on the failure modes. Originality/value This paper contributes to the quality risk assessment knowledge by introducing an integrated approach to evaluate and improve healthcare services quality. Also, the case study conducted on the CABG process has not been done by other related studies in the literature.

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The study emphasizes the superiority of the Plastibell device in circumcision, because of its simplicity and lower complication risk.

There is a high prevalence of aspirin resistance in diabetic patients and given that such patients are at risk of arterial thrombotic events, evaluation of aspirin resistance is suggested for those at a high risk of cardiovascular events or recurring events despite the use of aspirin.
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