Primiparous women's experiences of normal vaginal delivery in Iran: A qualitative study

Background: Childbirth is considered as the most challenging psychological event in a woman's life. It has a major effect on women's lives with long-term positive or negative impacts. Cultural, religious, and socioeconomic differences can affect women's perception about normal vaginal delivery (NVD) experience. Therefore, it is necessary to explore the primiparous women's perception about it. Methods: This qualitative study, with a descriptive content analysis approach, was conducted in Kashan, a city in the center of Iran. Purposive sampling was used to recruit the participants of the current study. Data was gathered by semi-structured interviews during 24 h after normal vaginal birth among primiparous women. The sampling started from June to October in 2016. Interviews continued until data saturation which was achieved in the 14th interview but for assurance, it continued until the 17th one. Results: The following three main themes were extracted "immersion in stress", "pain, the essence of NVD" and "strategies for situation management". Furthermore, seven subthemes were obtained including 'loss threat', 'stressful context', temporary impairment in physiologic harmony, paradoxical emotions, self-management, emotional support, and spiritual support. Conclusions: This study showed that stress and pain were two highlighted issues in NVD process. Increasing women's awareness about NVD process, familiarizing the primiparous women with the simulated delivery room, accompanying these women for emotional support, and providing spiritual support can be effective in situation management to make the child delivery a pleasant and satisfying experience. © 2020 The Author(s)

Features of childhood acute myeloid leukemia in Iran: A report from double center study

Acute Myeloblastic Leukemia is one of the important malignancies in children. For better managing the prognosis of this disease, there should be enough information about common features of this malignancy. The aim of this study was to evaluate these common features in children with Acute Myeloblastic Leukemia. A total of 104 eligible children less than 15-year-old have been referred from 2007-2011 to two referral centers for childhood malignancies. Basic epidemiological information recorded in checklists for each individual. Analyzes have been done by SPSS version 22. Out of patients, 57 cases were males (54.8). The male/female ratio was 1.2. The mean age of patients was 6.5 ± 4.3 years. The majority subtypes of patients were M3, M4, non-M3, and M2, respectively. The common molecular abnormalities were t (15;17) and inv (16). Of patients, 19.2 had an early relapse. The mean age of relapse in patients was 6.7 ± 3.9 years. Sixty patients (57.7) were alive, and 44 cases (42.3) died during or after therapy. The three years overall survival rate of patients was 42 in this study. According to our data, AML has the same frequency as compared with data from developing countries. But different epidemiological characteristic was a lower rate of three years overall survival in patients. These data may serve the health authorities for more effective environmental and preventive measurements, purposeful allocation of resources for facilitating upto-date diagnostic and treatment modalities, psychological support programs for respective family members and educational purposes. © 2015 Tehran University of Medical Sciences. All rights reserved

Serological Markers for Inflammatory Bowel Disease in AIDS Patients with Evidence of Microbial Translocation

Background: Breakdown of the gut mucosal barrier during chronic HIV infection allows translocation of bacterial products such as lipopolysaccharides (LPS) from the gut into the circulation. Microbial translocation also occurs in inflammatory bowel disease (IBD). IBD serological markers are useful in the diagnosis of IBD and to differentiate between Crohn's disease (CD) and ulcerative colitis (UC). Here, we evaluate detection of IBD serological markers in HIV-infected patients with advanced disease and their relationship to HIV disease markers.Methods IBD serological markers (ASCA, pANCA, anti-OmpC, and anti-CBir1) were measured by ELISA in plasma from AIDS patients (n = 26) with low CD4 counts (<300 cells/$\mu$l) and high plasma LPS levels, and results correlated with clinical data. For meta-analysis, relevant data were abstracted from 20 articles. Results: IBD serological markers were detected in approximately 65% of AIDS patients with evidence of microbial translocation. An antibody pattern consistent with IBD was detected in 46%; of these, 75% had a CD-like pattern. Meta-analysis of data from 20 published studies on IBD serological markers in CD, UC, and non-IBD control subjects indicated that IBD serological markers are detected more frequently in AIDS patients than in non-IBD disease controls and healthy controls, but less frequently than in CD patients. There was no association between IBD serological markers and HIV disease markers (plasma viral load and CD4 counts) in the study cohort. Conclusions: IBD serological markers may provide a non-invasive approach to monitor HIV-related inflammatory gut disease. Further studies to investigate their clinical significance in HIV-infected individuals are warranted

The viewpoints of undergraduate nursing students about the importance of caring behaviors at the beginning, middle, and end of their nursing education

Background & Aim: Caring viewpoint is a requisite of high quality nursing care. It must be operational through the nursing education program. The present study was conducted to compare the viewpoints of undergraduate nursing students at the first, fifth, and eighth semesters about the importance of caring behaviors during their nursing education. Methods & Materials: The present study is a descriptive-analytical study. In this study, three groups of 40 nursing students (semester one, five and eight) were selected by random sampling from Shahid Beheshti University of Medical Sciences in 2014. Caring Behavior Inventory completed through self-report by the students, was used for collecting data. Data were analyzed by the descriptive and inferential statistics (with the significance level<0.05) using SPSS software (version 20). Results: The mean scores based on Caring Behaviors Inventory in three groups were: semester 1: 148.2, semester five: 123.6, semester eight: 122.05. ANOVA showed statistically significant differences between the mean scores for three groups of students (P<0.001). Also, the scores of students� viewpoints were different in all instrument domains included respectful deference to the other (P<0.001), assurance of human presence (P<0.001), positive connectedness (P<0.001), professional skills and knowledge (P=0.004), attentiveness to the other�s experience (P<0.001). Considering the lack of homogeneity in the groups in terms of age and sex, analysis of covariance was used to eliminate their confounding effects on main variable, and despite controlling for the confounding role of age and sex, differences were significant (P<0.001). Conclusion: The viewpoints of the higher-year students about the importance of caring behaviors not only had not promoted but also it had decreased compared to the lower-year students. Considering the fact that caring viewpoint is the requisite of high quality nursing care that must be operational through nursing education programs, and due to the fading of emotional aspect of care, more emphasis on clinical instructors and nurses and using mentors in clinical practice are needed to practically and concretely show nursing students the emotional aspect of caring. © 2015, Tehran University of Medical Sciences (TUMS). All rights reserved

Desquamative enteropathy and pyloric atresia without skin disease caused by a novel intracellular beta4 integrin mutation

ITGB4 mutation may induce a desquamative enteropathy in infancy without significant skin disease. A history of pyloric atresia is important in infants with severe chronic diarrhoeal disease and should prompt investigation for JEB-PA associated mutations. Acquired immune responses may exacerbate primary genetic disorders of epithelial adhesion and immunomodulatory therapy may be beneficial