The relationship between cleft palate repair technique and audiological outcomes: A retrospective cohort study

Objective

Otitis media with effusion is common in children with cleft palates. This study aimed to investigate the link between palatal closure techniques and audiological outcomes.

Methods

In this retrospective-prospective cohort study, we examined the relationship between palate repair techniques and hearing outcomes in children with cleft palates. From 2017 to 2022, 190 ears of 95 cleft patients were studied at the Cleft Lip and Palate Department of Shiraz University of Medical Sciences. Variables assessed included the surgical technique, cleft severity, auditory brainstem response (ABR) threshold, and tympanometry configuration.

Results

The mean ABR improved from a prepalatoplasty value of 39.51(11.62) decibels (dB) to a postpalatoplasty mean of 26.61(11.60) dB (Cohen's d: 1.12 [95% CI; 0.90-1.34]). Initially, 87.9% of the studied ears exhibited abnormal tympanometry, but this significantly decreased to 47% postsurgery (risk ratio: 4.43 [95% CI; 1.20-16.43]). When compared with Sommerlad intravelar veloplasty, the Nadjmi modified Furlow palatoplasty was associated with a notably lower mean ABR (β: -6.58 [95% CI: -10.43 to -2.73], p-value = .001) and a reduced frequency of abnormal tympanometry (odds ratio [OR]: -1.10; 95% CI: -1.85 to -0.36, p-value = .004). Factors like prepalatoplasty ABR, cleft palate severity, gender, and syndromic did not confound these findings.

Conclusions

Although the Nadjmi modified Furlow palatoplasty showed better results, our findings indicate a significant improvement in ABR and tympanometry outcomes for both techniques. Future randomized controlled trials are suggested to confirm the influence of palatal closure techniques on audiological outcomes.

Level of Evidence

3b.

Relationship between sleep quality and marital satisfaction of working women during the premenopausal period

Sleep disorders can adversely affect physical, sexual, and marital health, particularly among middle-aged women. This study aimed to determine the relationship between sleep quality and marital satisfaction of working women during the premenopausal period. In this cross-sectional study, we selected 150 women working at Shiraz University of Medical Sciences in Iran was selected using random cluster sampling. A demographic information form, the Pittsburgh Sleep Quality Index (PSQI), and the Evaluation and Nurturing Relationship Issues, Communication, and Happiness (ENRICH) marital satisfaction scale were used for data collection. The Data were analyzed using SPSS.22 software at a significance level of P < 0.05. Multiple linear regression analysis was employed to predict sleep quality based on marital satisfaction. Our results showed that 79 (52.7%) of the participants had undesirable sleep quality, 87 (58%) had high marital satisfaction, and 32 (21.3%) had very high marital satisfaction. Regression analysis revealed that the total marital satisfaction score could not predict the sleep quality score of the participants. However, as dimensions of marital satisfaction, personality issues negatively (β = 0.327, P < 0.05) and ideological orientation positively (β = 0.336, P < 0.01) predicted the sleep quality score. Based on the prediction of the sleep quality score by personality issues and ideological orientations among the dimensions of marital satisfaction, it seems that life skills training, especially in these two dimensions, may improve the quality of sleep and, as a result, the physical and mental health of working women.

Investigating the relationship between resilience and professional ethics in nurses: a cross-sectional study in southern Iran

INTRODUCTION

All businesses that deal directly with clients need to observe ethics, but in the nursing profession due to its nature, compliance with professional ethics becomes more necessary. On the other hand, nurses face tensions and difficult conditions in their daily work environment. Resilience is one of the most important abilities of human beings, which in difficult conditions causes effective adaptation to stress-causing factors. Therefore, the relationship between resilience and professional ethics becomes important.

THE AIM OF THE STUDY

The present study was conducted to investigate the relationship between resilience and professional ethics in nurses of Shahid Ganji Hospital, Borazjan 2022-2023.

METHODS

The current study is a cross-sectional descriptive-analytical study. The study environment was Shahid Ganji Hospital in Borazjan, Bushehr, Iran. The research method of the current study was census, so all 400 nurses of this hospital were invited to participate in the study. Finally, 340 of them were included in the study based on the inclusion criteria. Data collection tools included a demographic information form, Connor-Davidson questionnaire, and Cadozier professional ethics questionnaire. Data analysis was done using SPSS version 22 software.

RESULTS

Most of the participants were between 25 and 30 years old. The average overall score of resilience and professional ethics of nurses participating in the study was 64.1 ± 16.3 and 34.3 ± 9.4, respectively. No significant difference was observed between the demographic characteristics of nurses with resilience and professional ethics. The Spearman correlation coefficient indicated a statistically significant and inverse relationship between professional ethics and resilience levels (r = -0.265, P < 0.001).

CONCLUSION

The present study demonstrated a significant and inverse relationship between professional ethics and resilience among nurses. Furthermore, professional ethics were at a moderate level, while resilience was at a good level. Therefore, it is recommended that enhancing professional ethics skills through the organization of educational workshops for nurses should be considered by nursing managers.

Preconception care, prenatal care, and postpartum bonding in women with substance use

Background

The status of care in the preconception and pregnancy periods in women who use substances can have an impact on maternal and neonatal health. This study aimed to assess the provision of preconception care, prenatal care, and postnatal mother-to-child bonding among pregnant women who use substances.

Methods

An ambidirectional cohort study was conducted, involving 69 pregnant women who reported substance use and had it confirmed using a ten-parameter panel kit (M10T) manufactured by Hannan Teb Pars Company. These women were selected from a referral maternity hospital between January and December 2020, using a convenience sampling method. Sociodemographic information, obstetric and medical history, and information about preconception and prenatal care were collected. All maternal and neonatal outcomes were recorded from the time of admission to the time of discharge for both the mothers and their neonates. Neonatal abstinence syndrome and mother-to-child bonding were assessed using modified Finnegan's neonatal abstinence tool and a postpartum bonding questionnaire, respectively. The data were analyzed using descriptive and inferential tests using SPSS software version 22.

Result

The mean age of the women was 32.8 ± 5.7 years. The mean duration of substance use was 5.1 ± 3.5 years. 48% of the pregnancies were reported as unwanted. A total of 94.2% and 50.7% of pregnant women did not receive preconception care and prenatal care, respectively. There was no association between pregnancy wantedness and receiving preconception care (P = 0.287), but a significant association was observed for prenatal care (P < 0.001). 31% of the mothers experienced a mother-to-child bonding disorder, with 75% of those who had unwanted pregnancies reporting such a disorder.

Conclusion

The findings of this study indicate that the majority of pregnant women who use substances did not receive preconception care, and prenatal care was inadequate with fewer visits than recommended. One-third of the pregnant women who use substances experienced a mother-to-child bonding disorder. It was also observed that women with unwanted pregnancies had poorer perinatal care and mother-to-child bonding.

Comparing the healing properties of intra-articular injection of human dental pulp stem cells and cell-free-secretome on induced knee osteoarthritis in male rats

OBJECTIVE

Osteoarthritis (OA) is a common and painful joint disease with multifactorial causes. Stem cells, due to their high ability to reproduce and differentiate, have created a new horizon in tissue engineering of cartilage and bone. Secretions are one of the new therapies that can be used with stem cells or separately. This study aimed to compare the healing effects of human dental pulp stem cells, cell-free secretome, and human dental pulp mesenchymal stem cells with secretome in the induced OA in male rats.

METHODS

Dental pulp mesenchymal stem cells were isolated and prepared from human dental pulp. The collagenase type II was injected into the knee of twenty-five male Sprague-Dawley rats, and after 10 weeks, OA was confirmed. Rats were divided into five groups (n = 5): 1) Human dental pulp stem cells plus secretome (HDP+Sec); 2) Human dental pulp stem cells (HDP); 3) Secretome (Sec); 4) Hyalgan as the positive control (Hya); 5) No treatment as the negative control (Ctrl). After 12 weeks since OA was confirmed, the healing process was examined by histopathology and radiology evaluations.

RESULTS

Histopathological evaluations, radiological assessments, and matrix indexes in three treatment groups significantly improved compared to the Ctrl and Hya groups. Surface in HDP+Sec was significantly better than the Ctrl group. In radiological evaluations, a significant decrease in OA was observed in the three treatment groups in comparison with the Ctrl groups. There was no significant difference between the treatment groups in any radiological and histopathological evaluations. HDP + Sec group slightly records better results compared to Sec or HDP treatment groups.

CONCLUSION

It was concluded that human dental pulp stem cells and their secretome promote cartilage regeneration due to their cell protective potential as well as matrix degeneration reduction capacity.

Novel strategy of cartilage repairing via application of P. atlantica with stem cells and collagen

Osteoarthritis (OA) is an inflammatory joint condition, still lacking effective treatments. Some factors consider as the main causes of OA, including biochemical, mechanical, and genetic factors. The growth of studies confirmed that modern medicine in combination with folk medicine regarding the arrival of reliable, efficient, and safe therapeutic products against OA. In the present study, the effects of various single and combinatorial treatments of knee articular cartilage, including stem cells, collagen, and P. atlantica hydroalcoholic leaves extract were investigated in a rat-induced OA model. On week 12 after OA confirmation, histopathology and radiography assessments were evaluated and the serum and synovial fluid levels of TAC, TNF-α, PEG2, MPO, MMP3, MMP13, and MDA were also measured. Combination therapy of OA-induced rats with hydroalcoholic extract of P. atlantic leaves, stem cells, and collagen considerably increased the efficacy of treatment as evidenced by increasing the TAC and lowering TNF-α, MPO, MMP3, and MMP13 compared to control group and even groups received single therapy. This is in agreement with a high amount of total phenolic compounds and antioxidant capacities of the hydroalcoholic extract of P. atlantic leaves. It is concluded that multifunctional agents targeting the pathophysiology of OA has exhibited significant therapeutic effects against OA.

Associations of insulin resistance, sex hormone-binding globulin, triglyceride, and hormonal profiles in polycystic ovary syndrome: A cross-sectional study

Background

Insulin resistance (IR) occurs in 50–70% of women with polycystic ovary syndrome (PCOS) and can be applied as a prediabetic feature in PCOS.

Objective

In this study, indirect methods including fasting blood sugar (FBS), fasting insulin (FI), FBS/FI ratio, and quantitative insulin sensitivity check index (QUICKI) were compared with the homeostasis model assessment of insulin resistance (HOMA-IR) as a standard technique. The association of IR to sex hormone-binding globulin (SHBG) and several hormones was also analyzed.

Materials and Methods

This cross-sectional study was performed on 74 PCOS women. Sensitivity and specificity of each IR method was calculated based on HOMA-IR. Hormonal profiles of the patients were compared between the groups with defined normal and abnormal values of IR.

Results

Triglyceride levels had a positive association with FBS and HOMA-IR (p = 0.002 and p = 0.01, respectively) with a negative association to QUICKI and SHBG (p = 0.02 and p = 0.02, respectively). SHBG showed a significant negative association with FBS (p = 0.001). Dehydroepiandrosterone sulfate showed a positive association with FI (p = 0.002). Seven PCOS women showed abnormal SHBG levels (< 36 nmol/L) while expressed normal values of the rest of the studied variables. FI and QUICKI had the highest sensitivity while FBS/FI and QUICKI had the highest specificity when HOMA-IR was applied as a standard test.

Conclusion

SHBG and triglyceride had a significant negative and positive association with IR, respectively. HOMA-IR followed by FI and QUICKI is the most sensitive test for the detection of IR. SHBG levels can be a helpful biomarker for the diagnosis of PCOS.

Determining an optimal cut-off value for follicle-stimulating hormone to predict microsurgical testicular sperm extraction outcome in patients with non-obstructive azoospermia

Objective To determine the optimal cut-off value for follicle stimulating hormone (FSH) to predict the outcome of microsurgical testicular sperm extraction (micro-TESE) in patients with nonobstructive azoospermia (NOA). Subjects and methods We included a total number of 180 patients with NOA. The serum level of FSH was determined and all the subjects underwent micro-TESE. We determined the optimal cut-off value for FSH and assessed whether the test could be effectively used as a successful predictor of sperm retrieval by calculating the Receiver Operating Characteristic (ROC) area under the curve. Results Overall we included a total number of 171 patients with mean age of 34.3 ± 8.6 years. The micro-TESE was considered to be successful in 79 (43.8%) while it failed in 92 (56.2%) patients. We found that the mean level of serum FSH was significantly higher in group those with failed micro-TEST compared to successful group (p < 0.001). The cut-off value for FSH was calculated to be 14.6 mIU/mL to predictive the outcome of micro-TESE with a sensitivity of 83.5% [73.5%-90.9%] and a specificity of 80.3% [69.5%-88.5%]. At this value, the other parameters were calculated to be PPV, 81.5%; NPV, 82.4; LR+, 4.23; and LR-, 0.21. Conclusions The results of the current study indicate that FSH plasma levels above 14.6 mIU/mL can be considered to be the failure predictor of the micro-TESE in NOA patients.

Longitudinal standards for growth velocity of infants from birth to 4 years born in West Azerbaijan Province of northwest Iran

OBJECTIVES:

Growth velocity is an important factor to monitor for appropriate child growth. This study presents the growth velocity of infants based on length, weight, and head circumference.

METHODS:

The subjects of this study were 308 neonates (160 boys and 148 girls) born in West Azerbaijan Province of northwestern Iran who were followed from birth for 4 years. The weights and lengths of the subjects were recorded at birth, 1, 2, 4, 6, and 9 months, and 1, 1.5, 2, 3, and 4 years of age, while the head circumferences were measured just up to 1.5 years of age. In this study, the Lambda-Mu-Sigma (LMS) method using LMS Chartmaker Pro (Institute of Child Health, London, UK) was utilized to obtain growth velocity percentiles.

RESULTS:

After obtaining growth velocity charts for weight, length, and head circumference (5th, 50th, and 95th percentiles), the researchers could deduce that there was a sharp decrease in the velocity growth charts from birth to 2 years of age but these charts remained relatively stable up to 4 years for both sexes. Growth velocities for the length and weight of boys in the present sample are slightly but not significantly greater than those in girls through the first months of infancy and there was no significant difference between girls and boys up to 4 years.

CONCLUSIONS:

This paper provided the first local growth velocity standards of length, weight, and head circumference for infants by analyzing longitudinal measurements produced for West Azerbaijan Province, which should be updated periodically. It seems that there has been a significant difference between the growth velocity of infants in northwestern Iran and southern Iran within the past few years.