Background Premature ovarian failure (POF)/premature ovarian insufficiency (POI) is characterized by disrupting ovarian function under 40 years old. A major health problem of this disorder is female infertility. There are no proven treatments to increase the rate of pregnancy with autologous oocytes in these patients. This review aims to summarize our present knowledge about POI-induced infertility treatments and to highlight the importance of future researches in the discovery of diagnostic biomarkers and treatment of patients with this disorder. Methods A literature review was carried out using PubMed and Google Scholar databases by relevant keywords, such as POI, POF, premature ovarian failure, premature ovarian insufficiency, and biomarkers. Results Two hundred three studies were included in the study following the search for the keywords. Titles and abstracts of the identified articles were evaluated for detecting relevant full-length articles. Conclusion Anti-Mullerian hormone (AMH) level appears to have considerable value as a diagnostic test for POI, but it is not reliable enough to be able to predict accurately the timing of onset of impending POI. Using an accurate biomarker, POI can be diagnosed early and infertility treatment that is concerned about can be done on time. Biomarkers in combination with other diagnostic tests could result in prediction of POI before the development of complete ovarian failure.
Background: The phenomena of transformation from the intrauterine environment to independent breathing proceeds successfully in 90% of newborns. However, timely resuscitation is crucial for the 10% remaining. Objectives: We investigated the neonate resuscitation (NR) status, predisposing factors, and outcomes. Methods: This retrospective descriptive research was conducted at Al-Zahra hospital (Guilan-Iran) between April 2018 to March 2019. During the study period, all files of born neonates were reviewed, and relevant maternal and neonate information was extracted and analyzed. Results: A total of 4,850 files were reviewed, and the data from 2,131 complete ones were analyzed. Among them, 14.1% needed resuscitation, 10.2% basic interventions, while 3.9% required advanced interventions. Neonate resuscitation outcome was significantly associated with gestational age (in less than 32 gestation weeks, 84.9% of neonates needed resuscitation) (P < 0.001), meconium staining of amniotic fluid (in 38.3% of cases whose amniotic fluid was stained with meconium, resuscitation was required) (P < 0.001), mode of delivery (in cesarean delivery, 18.7% of infants were resuscitated) (P < 0.001), birth weight (49.3% of infants weighing less than 2,500 grams needed resuscitation) (P < 0.001), multiple pregnancies (in multiple pregnancies, 66.1% resuscitation was needed (P < 0.001), Apgar score at minute 1 and 5 (in infants with an Apgar score below 7 in minute 1, 57.7% and in infants with an Apgar score below 7 in minute 5, 90.8% of neonates needed resuscitation) (P < 0.001). Conclusions: Screening pregnant women for early detection of high-risk cases and attendance of a skilled NR team at the time of delivery results in better outcomes.
Background: Breaking bad news is an unpleasant task for physicians, especially for patients with cancer. In this regard, the SPIKES protocol, which is prevalent in several countries, has not been discussed in Iran. Objectives: This study evaluated how the SPIKES protocol was followed by physicians. Materials & Methods: This descriptive cross-sectional study was conducted at Guilan academic hospitals from December 2021 to April 2022. Patients with cancer participated in the survey who were referred to the oncology academic centers for follow-ups or radiotherapy and chemotherapy. They were over 18 years old with the ability of proper communication. The SPIKES questionnaire consists of 12 questions with 6 subscales (settings, invitation, perception, knowledge, emotion, and strategy). It was filled out through a direct interview. Results: The data from 280 patients were analyzed. Everyone stated that at the time of receiving the diagnosis, the doctor was not in a hurry and made appropriate eye contact. About 61.1% believed they were emotionally supported, and 65.4% were satisfied with their final knowledge about the disease and treatment planning. Patients with older ages and lower levels of education were significantly more likely to state that physicians’ language was not comprehensive; physicians did not understand them, and the patients were not emotionally supported (P=0.0001). Conclusion: This study showed that more attention should be paid to older patients with lower levels of education. They needed more time for conversation and simpler dialect. Some areas, such as “invitation” are required to be improved
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