Original Article

Twin in compared with singleton pregnancies complicated by Preterm premature rupture of membranes (PPROM)

Masoumeh Mirzamoradi, Maral Baleshi, Nayereh Rahmati, Vajiheh Hazari, Maedeh Daraei, Zahra Heidar

Novelty in Biomedicine, Vol. 8 No. 3 (2020), , Page 103-108

Background: Our purpose was to compare the latency periods of preterm premature rupture of the membranes (PPROM) in twin compared with singleton pregnancies from 24 to 34 weeks' gestation and assessment of respiratory distress syndrome (RDS) between twins and singletons.

Materials and Methods: Between 2010 and 2014 in Mahdieh Hospital, Tehran, Iran, data on all women with singleton and twin gestations complicated by PPROM were reviewed. Latencies between singleton and twin pregnancies were compared. An additional comparing according to PPROM at under, equal and above 30 weeks' gestation was surveyed in these groups. In addition, their latencies compared among them. Use of surfactant consumption and need for intubation were measured during hospitalization between twins and singletons.

Results: The mean latencies of singleton and twin pregnancies were statistically significant without comparing the gestational age at PPROM (8.22±7.4 vs. 5.54±3.36 days, p=0.001). When PPROM occurred at < 30 weeks' gestation, latency in twins was not statistically significant (8.24±9.81 vs. 8.24±4.71 days, p=0.07) but at > or = 30 weeks' gestation, latency was significantly different in singleton and twin pregnancies (6.3±5.85 vs. 2.42±2.60 days, p=0.002). There were significant differences in the use of surfactant and intubation between twin and singletons (p<0.05).

Conclusion: This study provides the basis for effective patient counseling and managing pregnancies with PPROM. Overall, in pregnancies with PPROM at > or = 30 weeks' gestation, latency in twins was significantly shorter than in singleton pregnancies. For fetal lung maturity, the use of surfactant and intubation increased in twins compared with singletons.

Background: The aim of this study was to compare the effectiveness of cognitive-behavioral therapy and acceptance-commitment based therapy in decreasing drug craving in women who were addicted to the crystal.

Materials and Methods: The research method was quasi-experimental pre-test-post-test with the control group and two methods; the cognitive-behavioral, and the acceptance and commitment therapy were separately followed for two experimental groups with a follow-up phase. The statistical population of this study was all women who were addicted to the crystal that referred to addiction treatment centers in Isfahan province during the period of August to October 2017. They were simultaneously depressed. The instruments used in the study were the Wilson, Guilford and Concrete protocol (2004) that is the treatment based on the acceptance, Carole's cognitive-behavioral therapy (1998), and Frankl (2002) craving for drug questionnaire, as well as repeated measures of variance analysis.

Results: Findings showed that cognitive-behavioral and acceptance and commitment therapies for craving of crystal usage are effective in women who have had crystal abuse. Between two methods of cognitive behavioral therapy, and acceptance and commitment therapy in the field of craving for the crystal in women that overcome drug addiction, there was a significant difference. The acceptance and commitment therapy had effects that are more therapeutic.

Conclusion: Therefore, this study provides a total empirical support for acceptance-based and commitment treatment in the treatment of women who were overcoming the crystal addition.

Background: Sacroiliac joint dysfunction is one of the main sources of lower back pain affects 16-30% of these patients. Various treatments had proposed for subluxation and sacroiliac syndrome but the current evidence on this subject is not confirmatory and few surveys have assessed the efficacy of manipulation in the treatment of this condition. The present study aimed to compare the efficacy of manipulation with exercise therapy in patients with sacroiliac pain syndrome.

Materials and Methods: In this single-blinded clinical trial, the 30 patients categorized (to two groups) to receive either manipulation or exercise therapy. Required data gathered via medical history and the Persian translation of the Beck and Oswestry questionnaires and the pain assessed according to the visual analogue scale (VAS). Data entered into SPSS v.22 software for analysis.

Results: Changes in VAS (p=0.011) and Oswestry score (p=0.012) after one week were significantly greater in the manipulation group. In addition, changes in the Oswestry disability index (ODI) score in the manipulation group of one week and one month after treatment were significantly different from the pre-treatment.

Conclusion: Based on the findings of this survey, manipulation had a better efficacy on pain severity and disability of patients with sacroiliac pain syndrome, compared to exercise therapy and considering its low risks and non-invasiveness, its application by trained physicians recommended.

Effects of low level laser therapy on mucositis in patients under chemotherapy and bone marrow transplantation

Azad Tavakoli, Mahdi Tabarraee, Faraj Tabeie, Mahshid Mehdizadeh, Mojtaba Ghadiani, Leila Izadi Masoole

Novelty in Biomedicine, Vol. 8 No. 3 (2020), , Page 125-128

Background: Oral mucositis is among the most important adverse effects of chemotherapy and bone marrow transplantation and prevention from this side effect is important to improve the situations in patients. Hence, in this study the main aim was to determine the effects of low-level laser therapy on mucositis in patients under chemotherapy and bone marrow transplantation.

Materials and Methods: In this randomized controlled clinical trial, 60 consecutive patients under chemotherapy and bone marrow transplantation in a training hospital in 2018 were enrolled and randomly assigned to receive either low-level laser therapy (630 and 780 nm) or off-laser. Finally, the frequency rate and severity of mucositis (grades 0 to 4 according to WHO severity index) were determined and compared across the groups.

Results: Mucositis was present in 30% and 56.7% in laser and control groups, respectively with statistically significant difference (p=0.037). The severity of mucositis was same across the laser and control groups (p=0.785).

Conclusion: Low-level laser therapy is an effective modality for preventing from mucositis in patients treated by chemotherapy and bone marrow transplantation. Accordingly, utilization of this safe and effective therapeutic method is recommended.

Background: Streptococcus pneumoniae commonly asymptomatically colonizes the human upper respiratory tract and the carriage rate varies between geographical regions. The colonized individuals are not only at risk of infections but also can be a source of transmission of the pathogen. The risk of the droplet or airborne transmission of pneumococcal strains healthcare workers is considerable.  The current study aimed to determine the extent of nasopharyngeal colonization with S. pneumoniae and their levofloxacin susceptibility at a tertiary hospital in Tehran, Iran.

Materials and Methods: During a six-month period, the nasopharyngeal swab samples collected from 300 volunteer healthcare workers of Imam Hossein Hospital. Samples screened for S. pneumoniae using standard conventional biochemical methods. The minimum inhibitory concentration (MIC) of levofloxacin was determined using a commercially available strip antibiotic test according to the clinical laboratory standards institute (CLSI) guidelines.

Results: A total of 19 (6.3%) enrolled healthcare workers were colonized with S. pneumoniae. Amongst the enrolled volunteers, nurses had a higher rate of pneumococcal colonization (47.3%) followed by interns (21%) and laboratory workers (15.8%). Our analysis revealed that there was a significant correlation between smoking and pneumococcal colonization. The antimicrobial susceptibility testing showed that all of the isolates were susceptible to levofloxacin (MIC≤2 μg/ml).

Conclusion: This low rate of pneumococcal colonization amongst healthcare professionals may be attributed to the low risk of horizontal transmission of severe pneumococcal infections in the hospital. Additionally, our findings indicated that levofloxacin was an effective antimicrobial agent for the treatment of pneumococcal infections.

Heart Diseases Associated Genes

Fatemeh Zahedipour, Rouzbeh Chegeni, Shivasadat Gheflat, Mojgan Bandehpour

Novelty in Biomedicine, Vol. 8 No. 3 (2020), , Page 135-141

Background: Heart diseases are complex pathophysiologic conditions involving biomarkers. Understanding the mechanisms by which a gene selectively triggers intracellular molecular responses provide insight into the complex processes implicated in heart diseases. The aim of this study was to predict heart diseases associated genes.

Materials and Methods: A number of computational methods have been developed for human gene prioritization. In this study, we used Beegle and KEGG pathway databases and two online services for gene prioritization and analysis of genes related to heart disease.

Results: Over 200 genes and 5 key signaling pathways related to human heart diseases were found. The processes in which gene mutations trigger a response in cells leading to cardiac conditions involve multiple pathways.

Conclusion: The genes related to heart diseases could be CRP, NPPB, IL-6, ACE2 and GATA4 with high scores and the researchers should find the diagnostic biomarker between them.

Evaluation of Pregnancy Outcomes in Iranian Women with Uterine Myomas

Masoumeh Mirzamoradi, Masoumeh Aslanpour, Mina Bakhshali Bakhtiari, Raziyeh Jamali, Marziyeh Jamali

Novelty in Biomedicine, Vol. 8 No. 3 (2020), , Page 142-145

Background: To investigate the impacts of myomas on the outcomes of pregnancy in Iranian pregnant women with uterine fibroids.

Materials and Methods: In this retrospective cohort study, the consequences of myomas on pregnancy were investigated in Iranian pregnant women referred to the perinatology clinic of Mahdieh Hospital (Tehran, Iran). One-hundred and sixty pregnant women diagnosed with uterine myoma were enrolled in the study as the case group. The control group consisted of 160 pregnant women without fibroma. The characteristics of the myomas and their relationships with pregnancy outcomes were surveyed.

Results: Non-cephalic presentation, preterm labor, and Cesarean delivery were significantly higher in the case group in comparison with the control group. 106 patients (66.7%) had myomas larger than 5 cm in diameter. Intramural fibroids were seen in 132 (83%) patients. In addition, 133 (83.6%) patients had myomas in the body (corpus) of the uterus. Considering the number of myomas, 124 (78%) patients revealed one myoma in uterus. Uterine myomas during pregnancy rendered an important risk factor for cesarean delivery, breech presentation, and preterm delivery. However, there were no significant correlations between uterine myomas and IUGR, premature membranes rupture, either abortion or bleeding in the first trimester, low birth weight, and severe postpartum bleeding.

Conclusion: Our results showed that the presence of myoma could modulate pregnancy outcomes. Our results can be useful in improving the quality of prenatal care and education.

Case Report

Posterior Reversible Encephalopathy Syndrome during Pregnancy: A Case Report

Maasoumeh Mirzamoradi, Nayyereh Rahmati, Ayda Khandani, Nahid Rezaei Aliabad, Yekta Parsa

Novelty in Biomedicine, Vol. 8 No. 3 (2020), , Page 146-150

Background: Posterior reversible encephalopathy syndrome (PRES) is a neurological condition entity presenting with headache, confusion, seizure, altered mentation and loss of vision associated with white matter changes on imaging. The lesions in PRES are thought to be due to vasogenic edema, mainly in the posterior cerebral hemispheres.

Cases Report: This study has reported a patient who developed PRES without any indicators for preeclampsia-eclampsia in her pregnancy. The patient’s brain images showed abnormal signal intensity in the occipital lobe.

Conclusion: Posterior reversible encephalopathy syndrome is reversible when initial diagnosis established and suitable treatment start immediately.