BackgroundThis study aimed to evaluate quality of life and psychological distress in Iranian women with recurrent miscarriage and to compare it in women without miscarriage.MethodsThis was a comparative study of quality of life among women with and without recurrent miscarriage. Cases were selected from patients with complain of recurrent miscarriage and comparison group were selected from women attending to two teaching hospitals for annual screening. Quality of life (QOL) was measured using the 36-Item Short Form Survey (SF-36). In addition the Hospital Anxiety and Depression Scale (HADS) were used to measure anxiety and depression. Comparison was made between two groups using the independent samples t-test and chi-square.ResultsIn all 105 women with recurrent miscarriage and 105 healthy women were studied. The socio-demographic status for both groups was similar. Women with recurrent miscarriage showed a significant higher degree of psychological distress [mean (SD) anxiety score was: 10.6 (2.3) vs. 9.1 (2.2), P < 0.0001; and mean (SD) depression score was: 11.0 (2.3) vs. 9.5 (1.9), P < 0.0001]. In addition women with recurrent miscarriage reported significantly lower level of quality of life in all domains (role physical, general health, vitality, social functioning, role emotional, and mental health, all P values < 0.0001), except for physical functioning (P = 0.06) and bodily pain (P = 0.17).ConclusionThe findings demonstrated that women with recurrent miscarriage reported extensive functional disability, and lower level of well-being compared to women without recurrent miscarriage. The findings have some implications for prenatal care and suggest that appropriate treatment of recurrent miscarriage is essential.

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BackgroundAntimicrobial stewardship program (ASP) is a distinguished method to improve the prescription and efficacy of antibiotics.AimThe efficacy of ASP and conventional methods was compared to measure the effectiveness of meropenem (MPM) and vancomycin (VMN) antibiotics in pediatric patients.DesignIn an interventional quasi-experimental study, 135 children admitted in Children’s Hospital affiliated to University of Medical Sciences in time periods of 2014–2015 and 2015–2016 were assessed.MethodsThe conventional and ASP methods in 2014–2015 and 2015–2016 were respectively utilized to provide the best antimicrobial therapy of MPM and VMN antibiotics in patient children. The data of mortality rate (MR), antibiotic prescription (AP), antibiotic dose (ADe), antibiotic duration (ADn), length of hospital stay (LOHS), and blood cultures (BCs) were compared across the years using the Chi square, independent t test, and Fisher’s exact test.ResultsThe levels of MR, AP, ADe, ADn, LOHS, and positive BCs using the ASP method in 2015–2016 were significantly lower those of in 2014–2015 using the conventional one (p < 0.05).ConclusionsThe ASP method versus conventional one with a better efficacy can be employed as an antibiotic administration guide for MPM and VMN in the therapy of patients in community-based hospitals.

Background Physical inactivity enhances the risk of adverse health conditions such as non-communicable diseases, morbidity, and mortality among middle- and older-aged population. This study is aimed to design, implement, and evaluate a conceptual model of physical activity (PA) promotion among middle-aged Iranian women (MAIW). Methods An interventional study was conducted with 80 women aged between 30 and 59 years in intervention and control groups during 2018–2019. The subjects referred to health centers were selected by the available convenience sampling method. Data collection tools to assess the MAIW' PA level (metabolic equivalent tasks (MET)-min/week) included face-to-face interviews, body mass index (BMI) measurements, the four-question form of PA vital signs in the framework of Iran's Package of Essential Non-communicable (IraPEN) program, and the questionnaire is based on the Health Belief Model (HBM) constructs. Results The intervention led to a three-fold increase in the average PA (from 280.63 to 927.70 MET-min/week) of the intervention group. Although no significant difference in the BMI between both groups was found before the intervention, this educational program decreased the mean BMI from 30.36 to 28.83 kg/m2 (p = 0.01). After the intervention, the values of HBM-based perceived sensitivity/severity and self-efficacy were increased from 62.09 to 71.03% and from 27.01 to 83.15%, respectively (p < 0.0001). There were no significant differences in the cue to action and perceived benefits and barriers after the intervention. Conclusion The developed model by increasing the motivation of MAIW could remarkably improve the PA level with a decrease in their BMI. Trial register Iranian Registry of Clinical Trials (IRCT): IRCT20200717048124N1 at 2020-08-05, retrospectively registered.

BACKGROUND:Neonatal jaundice is one of the main causes of the patient’s admission in the neonatal period and is potentially linked to morbidity.AIM:This study aimed to determine the possible risk factors for neonatal jaundice.METHODS:We investigated the case of infants who were admitted to the neonatal department of Ziyaeian hospital and Imam Khomeini Hospital for jaundice. Simple random sampling was used to evaluate variables related to maternal and neonatal predisposing factors based on the medical records and clinical profiles. All variables in this study were analysed using SPSS software.RESULTS:In this study, about 200 mothers and neonates were examined. Our findings depicted that mother’s WBC, Hb, PLT, and gestational age were associated with jaundice (P < 0.05). Furthermore, there were significant relationships between different degrees of bilirubin with TSH, T4 levels and G6PD (P < 0.05). In fact, TSH, T4 levels and G6PD were found to be linked to neonatal hyperbilirubinemia. The risk factors for jaundice in our study population comprise some predisposing factors such as WBC, Hb, PLT, gestational age, TSH, and T4 levels, as well as G6PD. Neonates at risk of jaundice are linked to some maternal and neonatal factors that can provide necessary interventions to reduce the burden of the disease. Therefore, identification of associated factors can facilitate early diagnosis, and reduce subsequent complications.CONCLUSION:Neonatal jaundice should be considered as the main policy in all health care settings of the country. Therefore, identification of factors affecting the incidence of jaundice can be effective in preventing susceptible predisposing factors in newborns and high-risk mothers.

Background There is a high risk of COVID‐19 in kidney transplant recipients (KTRs) because of chronic immunosuppression and severe cytomegalovirus (CMV) pneumonitis. Case presentation A case series of 10 KTRs with COVID‐19 in Iran was developed. Participants consisted of two female and eight male patients, aged 46‐68 years old. The data related to clinical laboratory tests, outcomes, diagnosis, and drug treatments were collected. The RT‐PCR confirmed the COVID‐19 infection in KTRs. The assessment of serum biochemical and blood hematological factors showed that there was a strong correlation between COVID‐19 intensity and high serum Cr, BUN, and ALT levels, high CRP concentration, and lower lymphocyte and platelet counts in male KTRs. Ground‐glass opacity (GGO) was the main radiologic pattern visible on both chest radiographs of computed tomography scans. The COVID‐19 and CMV coinfection in KTRs resulted in large‐size kidneys with severe parenchymal echogenicity and hydronephrosis. The combined use of effective antibiotic and antiviral drugs was suitable to prevent COVID‐19 progression in KTRs. Conclusions The coincidence of COVID‐19 and CMV in KTRs may potentially increase the mortality risk of patients. The levels of Cr, BUN, ALT, and CRP as well as lymphocytes count in these patients should be continuously controlled.