zahra panahi

Bacterial infection among neonatal patients admitted to the neonatal intensive care unit (NICU) is a global crisis and is among the first causes of neonatal mortality globally. Hence, this study aimed to evaluate the prevalence of bacterial pathogens from collected samples of neonatal infection in the NICU of a tertiary care center in Tehran, Iran.
In this study, we used data from blood, ulcer/fluids, and urine samples of NICU neonates at Imam Khomeini Hospital from 2019 to 2022.
Overall, 712 urine cultures (144 positives), 4578 blood cultures (376 positives), and 1771 ulcer/fluid cultures (411 positives) were gathered. Among positive blood cultures, the most prevalent bacterial species was Klebsiella pneumonia (120, 32.88%). Among urine cultures, the most prevalent bacterial species was Klebsiella pneumonia (71, 49.31%). Among positive ulcer/fluid cultures, the most prevalent bacterial species were Coagulase Negative Staphylococci (150, 36.49%). The highest sensitivity of Klebsiella pneumonia was against Ciprofloxacin (15.83%) in blood samples and resistant to Gentamycin (81.67%). Among urine samples, the highest sensitivity of Klebsiella pneumonia was against Ciprofloxacin (29.58%%) and the highest resistance against Gentamycin (84.51%). Among the ulcer/fluid samples, the highest sensitivity of Coagulase Negative Staphylococci was against Ciprofloxacin (13.48%) and the highest resistance against Cotrimoxazole (14.81%).
The most prevalent bacterial species found were Klebsiella pneumonia and Coagulase Negative Staphylococci. These species showed high resistance against multi drugs such as Cotrimoxazole, Ampicillin-sulbactam, and Piperacillin-tazobactam. National health policymakers should focus on surveillance programs to control and monitor such trends in antibiotic resistance.

This study aimed to assess ophthalmic artery Doppler in combination with N-terminal prohormone of Brain Natriuretic Peptide in the prediction of pre-eclampsia (PE) at 28-32 weeks’ gestation.

This is a prospective study on singleton pregnant women who were referred to Imam Khomeini Hospital for routine pregnancy care at the gestational age of 28 to 32 weeks from June 2023 to June 2024. The mother's demographic information, medical history, bilateral ophthalmic artery Doppler, and NT-proBNP levels were recorded. Area under the curve (AUC) and logistic regression models were used to analyze the data.

Resuls:

 One hundred sixty pregnant women with a gestational age of 28-32 weeks were included, and 36 (22.5%) of them developed PE. The averages of PSV ratio in the PE pregnancies were 0.60±0.12, and in the normal pregnancies were 0.75±0.09. The average PSV ratio in the PE pregnancies was significantly higher than in normal pregnancies (P< 0.001). Also, the average PSV2 in PE pregnancies was significantly higher than in normal pregnancies (P < 0.015). The frequency of fetus death was higher in the PE pregnancies (P = 0.041). The ROC curve for PSV ratio in the prediction of PE showed that 0.69 was the best cut-off value of PR (sensitivity 0.83; specificity 0.81). The regression model for the development of PE revealed a significant association only with the PSV ratio (p = 0.016).

 At 28–32 weeks of pregnancy, the ophthalmic artery PSV ratio was found to be helpful in predicting future PE development, especially preterm PE. It could be valid on its own or in combination with other biomarkers. The mean of NT-proBNP in PE pregnancies was higher than in normal pregnancies. However, the differences were insignificant, and this insignificant difference in this study may be related to differences in the evaluation of participants during gestation weeks and differences in population samples between studies. More studies are needed to assess this biomarker in combination with ophthalmic artery Doppler to predict PE.

The inflammatory factors included Neutrophil-to-Lymphocyte Ratio (NLR), Procalcitonin (PCT), mean platelet volume (MPV), C-reactive protein (CRP), Ferritin, Lactate Dehydrogenase (LDH) and Acute Physiology and Chronic Health Evaluation II (APACHE II) score can affect disease outcomes in COVID-19 patients, and can help us in estimating the higher chance of death in severe patients. Our goal was to present the association of inflammatory factors with COVID-19 outcomes.  

As a retrospective cohort study a total of 369 intubated or hospitalized COVID-19 patients in the ICU during the year of 2021, were enrolled. Demographic data of patients collected by a questionnaire included age, sex, clinical information, and calculated their Neutrophils/Lymphocytes ratio (NLR) using the first complete blood count (CBC), PCT, MPV, CRP, and APACHE II on admission.  

Of 369 hospitalized patients with COVID19, the average NLR was 4.01 (95% CI: 3.58, 4.45) and the difference with non-intubated patients was 1.26 units (P<0.001). Intubated patients had much higher APACHE II score (29.18 (95%CI: 26.27, 32.08)) and difference of 6.49 units (P<0.001). Patients had an average CT severity of 29.18 (95%CI: 27.81, 30.54) and longer hospital stay was strongly and positively linked to higher NLR at baseline (P< 0.001; r=0.627).  

The study highlights that intubated COVID-19 patients exhibit significantly higher neutrophil-to-lymphocyte ratios and APACHE II scores compared to non-intubated patients, indicating a correlation between elevated NLR and prolonged hospital stays. These findings suggest that NLR may serve as a valuable prognostic marker in assessing the severity of COVID-19 in hospitalized patients.

The research combined different bibliometric techniques to analyze systematically recurrent pregnancy loss (RPL) documents from 1970 to 2023.

Overall, 1287 documents from the Web of Science database associated with recurrent pregnancy loss between 1970 and 2023 were identified for more than 300 journals. The data were analyzed with VOSviewer software.

The trend of paying attention to the topic of RPL can be divided into three periods. The number of publications on RPL increased significantly after 2010. Most of the papers were published in Obstetrics and Gynecology and Reproductive Biology areas. Utilizing co-occurrence and co-citation analysis, our study found that the most influential documents mapped the knowledge structure, and projected future research directions. The co-occurrence analysis showed five clusters even though the co-citation analysis designates four.

RPL has increased in recent years exponentially and some areas were explained carefully, therefore these results could be used as a research agenda for the future direction by a range of interested beneficiaries.

Despite the high efficacy of the Apgar score in finding respiratory distress, a low Apgar score doesn’t necessarily indicate fetal hypoxia-asphyxia. Umbilical Artery pH (UApH) is one of the best indicators of fetal hypoxia. Therefore, it’s so beneficial to consider these criteria and their relationship with the Apgar score for accurate diagnosis of prenatal respiratory distress retrospectively which reduces the unnecessary cesarean section (CS) rate.

162 full-term (≥259 days) neonates delivered by CS with the diagnosis of decreased fetal heart rate (FHR) were evaluated. 1-min and 5-min Apgar scores and UApH were measured. The correlation between Apgar scores with UApH and the association between UapH and Apgar with the NICU admission were evaluated. The effect of other variables including mother’s age, gravidity, gestational age, birth weight, newborn sex, and causes of decreased FHR on Apgar scores and UApH were studied as well.

The most common cause of decreased FHR was fetal distress, boys had higher weight (P=0.033) and lower UApH (P=0.049) than girls. Other parameters were not different significantly between both sexes. There was a positive correlation between UApH and 1-min and 5-min Apgar scores (r=0.464 and r=0.370 respectively) when controlled for birth weight (P<0.0001). The RR for NICU admission in male acidemic neonates with abnormal 1-min Apgar was 14.05 (CI95%: 5.7-34.6) in comparison to females (RR=1.06, CI95%: 1-1.26).

Mild acidemia (UApH<7.2) at least in a male fetus would be a good predictor for postnatal complications and need for NICU admission. Future studies with more samples are suggested.

The purpose of this study was to compare the effectiveness of Buccal, Vaginal, and Sublingual misoprostol for induction of labor in term pregnancy.

The research was done as an RCT from 2017 to 2018. About 300 participants were randomly allocated to obtain 50 µg Buccal, 25 µg Vaginal, and 50 µg Sublingual misoprostol in Kosar Hospital, Qazvin, Iran. The maternal and fetal complications, Bishop score hour 1, and hour 6 were observed.

There were no differences between fetal complications (p>0.05) and maternal complications (p>0.05) among the three groups. Bishop score hour 1 (P = 0.146), Bishop Score hour 6 (P = 0.704), and total dose (P = 0.15) also were no differences among these groups. Our study found a difference between the three groups (P = 0.015) in achieving standard vaginal delivery within 24 hours, as Buccal, Sublingual and Vaginal groups were performed respectively. The use of Oxytocin in the Buccal group was higher than that of other groups (P = 0.022).

This study found that there is no difference in terms of fetal complications and maternal complications in the three groups, but there was a significant difference in Oxytocin use and vaginal delivery within 24 h from the start of induction.

 The coronavirus disease 2019 (COVID-19) vaccines are very good at protecting individuals from serious illness, needing hospital care, and dying from different strains of the virus. However, vaccines might not completely prevent individuals from catching and spreading the virus, and this might depend on some personal factors.

 To find out the immune response of COVID-19 vaccines, this cross-sectional study conducted within June 2021 to May 2023 assessed different types of COVID-19 vaccine antibody responses among healthcare professionals and their associations with demographic factors and comorbidity risk factors.

 This descriptive-analytical study was conducted on recruited healthcare professionals from Sina, Imam Khomeini Complex, 501 AJA, Baqiayatallah, and Firoozgar hospitals in Tehran, Iran. The vaccines whose antibody response was investigated in this study are Sinopharm® (China), AstraZeneca® (United Kingdom), Sputnik® (Russia), and Covaxin® (India). Anti-spike, anti-receptor-binding domain (RBD), and anti-neutralizing immunoglobulin G (IgG) were evaluated by commercial kits according to instructions.

 This study involved 1 029 healthcare workers who were over 18 years old. The average age was 41.48 ± 9.9 years, and 602 (58.5%) of them were male. The vaccines they received were Sputnik V (392 or 38.16%), AstraZeneca (335 or 32.61%), Baharat (45 or 4.3%), and Sinopharm (255 or 24.82%). The Covaxin and AstraZeneca vaccines increased both anti-RBD and anti-neutralizing IgG Ab levels; however, the Sinopharm vaccine increased only the latter. The Sputnik vaccine was the least effective. Gender and diabetes influenced the antibody levels, but age did not.

 This study revealed the substantial effectiveness of COVID-19 vaccines in generating robust antibody responses among healthcare professionals. All four vaccine types, Sinopharm, AstraZeneca, Sputnik, and Covaxin, elicited significant antibody responses in over 70% of participants, highlighting the crucial role of vaccination in building defense against COVID-19.

 Patients undergoing orthopedic surgery are at risk of nosocomial infections, and antibiotic resistance is known to increase the risk of such infections.

 We aimed to determine the rate of antibiotic resistance in patients admitted to orthopedic wards in one of the largest referral hospitals in Iran. We also ascertained responsible antibiotic-resistant microorganisms in patients with bone and joint infections.

 The present cross-sectional investigation was concluded over a period of five years, from March 2018 to February 2023, at a great referral hospital in Tehran. Laboratory data, including the organisms isolated and their antibiotic resistance patterns, were collected by reviewing the hospital information system.

 In total, 2650 specimens obtained from patients with suspected bacterial infections were transferred to the hospital’s laboratory, 880 (33.2%) of which were positive for bacterial infections. The maximum antibiotic resistance rate against an antibiotic was observed to be 58% for Staphylococcus aureus (erythromycin), 75% for Klebsiella pneumonia (ampicillin/sulbactam), 64.5% for Escherichia coli (imipenem), 76.2% for coagulase-negative Staphylococcus (vancomycin), 100% for Acinetobacter baumannii (imipenem), 52% for S. epidermidis (erythromycin), 85.9% for Enterobacter species (gentamycin), and 65.6% for Pseudomonas aeruginosa (ampicillin/sulbactam). The overall rate of multi-drug resistance was obtained as 27.6%.

 A high rate of resistance of various bacterial strains to common antibiotics, especially erythromycin, ampicillin, imipenem, vancomycin, and gentamycin, was denoted in orthopedic wards. Also, a high rate of multi-antibiotic resistance was encountered in these wards, where more than a quarter of the bacterial strains showed such resistance.

Today, the use of active packaging containing natural antimicrobial compounds such as essential oils and plant extracts has increased to increase the shelf-life of food  products. The purpose of this study is to investigate the effect of gelatin coating containing Citrus sinensis peel extract on increasing the shelf life of rainbow trout meat. Gelatin (4%) coating was prepared with different levels of Citrus sinensis peel extract (2% and 4%). After preparing the pieces of rainbow trout meat, all the pieces were coated and examined for chemical properties (pH, TVB-N, TBARS), microbial (TVCs and TPCs) and sensory properties (odor, color, texture and overall acceptance) were evaluated for 16 days at 4°C with a 4-day interval (0, 4, 8, 12, 16). The results of the investigation of the antimicrobial effect showed that in the samples coated with 2% and 4% levels of Citrus sinensis peel extract, the average count of mentioned bacteria was significantly lower than the control and gelatin alone (p < 0.05). The results of examining the chemical properties of the samples showed that pH, TVB-N and TBARS increased during the period, but this increase occurred at a slower rate in the samples coated with different levels of Citrus sinensis peel extract. In the evaluation of sensory characteristics, at the beginning of the study, all the samples had the highest acceptance limit, and with the passage of time and the appearance of signs of spoil, the scores decreased, especially in the control. Generally, the results showed that gelatin coating along with different levels of Citrus sinensis peel extract has a positive effect on increasing the shelf life of fish meat and these compounds can be used together to increase the shelf life of protein foods.

To investigate the association between intimate partner violence during pregnancy and maternal and neonatal outcomes.

This cross-sectional study was performed on 115 pregnant women referring to an academic center. Demographic data, maternal outcomes (vaginal bleeding during pregnancy, preterm delivery, intrauterine growth restriction, placental abruption, and premature rupture of membrane), and neonatal outcomes (birthweight and Apgar score) were evaluated. Domestic violence against pregnant women was ascertained by a validated domestic violence questionnaire. Finally, the association between domestic violence and maternal and/or neonatal outcomes was investigated.

The prevalence of domestic violence against pregnant women was 67.8%. Psychological violence obtained the highest prevalence (64.3%), followed by economic (34.8%), sexual (18.3%), and physical (12.2%) violence. Regression analysis showed that there was a significant association between domestic violence and preterm labor (P = 0.048, r = 0.385) and between economic violence and placental abruption (P = 0.040, r = 0.391). Also, there was a significant relationship between vaginal bleeding and sexual violence (P = 0.022). Educational level significantly and inversely correlated with economic (r = -0.21) and physical (r = -0.19) violence.

The results of this study indicated that intimate partner violence was commonplace during pregnancy and affected neonatal and maternal outcomes. It is suggested to implement educational programs for healthcare workers and screen all pregnant women for exposure to intimate partner violence to reduce maternal and neonatal complications.

Nuchal translucency (NT) and crown-rump length (CRL) measurements are useful fetal screening tests. The extent to which maternal hematological and biochemical profiles may impact these markers has not been evaluated. This study is designed to address this issue.

Data from the first-trimester screening for aneuploidy and maternal laboratory results, including maternal fasting blood sugar (FBS), thyroid stimulating hormone (TSH), hemoglobin, hematocrit, vitamin D3, and ferritin, were collected at 11 - 13 weeks of gestational age. The association between NT/CRL and maternal laboratory tests was analyzed and reported.

258 women with a mean ± SD age of 32.6 ± 5.2 years participated in the study. NT and CRL values were not correlated with maternal laboratory variables. Otherwise, CRL was positively correlated with increasing maternal age, and NT was associated with increasing gestational age.

The results of this study indicate that NT and CRL values at 11 - 13 weeks of gestation are independent of maternal hemoglobin, FBS, vitamin D3, and ferritin status.

This study aimed to evaluate the viability of encapsulated probiotics using electrospinning technique. Specifically, the study focused on polyvinyl alcohol-whey protein isolate nanofibers (PVA/WPI) containing Bifidobacterium bifidum. These nanofibers have potential applications in active food packaging to improve food safety and extend shelf life, as well as in medical and pharmaceutical fields.

PVA/WPI nanofibers were electrospun in varying ratios (ranging from 100:00 to 50:50) and evaluated for their morphology, mechanical properties, FT-IR and DSC characteristics. B. bifidum was also encapsulated in the optimized PVA/WPI nanofibers to assess their encapsulation efficiency and viability, and the antimicrobial properties of the nanofibers were determined using the disk diffusion method.

All prepared nanofibers displayed a diameter range of 186.42-612.5 nm, with an inverse relationship between WPI ratio and nanofiber diameter. The PVA/WPI nanofiber with a ratio of 60:40 was found to be the most favorable. DSC analysis showed that adding WPI decreased thermal stability, and the enthalpy of endothermic peaks decreased in nanofibers containing B. bifidum. Mechanical evaluation revealed that adding WPI reduced tensile strength and elongation at break, without significant effects from B. bifidum (P>0.05). Bacterial encapsulation efficiency was 80.58%. Probiotic nanofibers exhibited antimicrobial properties against Listeria monocytogenes (11.00±0.37 mm) and Escherichia coli (9.71±0.06 mm).

According to the obtained results, the optimized PVA/WPI nanofiber (60:40) contained suitable morphological, mechanical and thermal characteristics with the highest encapsulation efficiency in regards to B. bifidum (>80%). Probiotics-containing PVA/WPI nanofibers are a suitable platform for medical applications and food industry packaging due to their antimicrobial properties.

 Social factors which are integrated with health status are considered crucial in pregnancy morbidity. Mothers with a developed level of health literacy (HL) experience a lower risk of preterm delivery. This study aimed to evaluate the relationship between maternal HL and prenatal care and pregnancy outcome.

The research was a cohort study. A total of 323 participants were selected from prenatal clinics. The women were followed until delivery. Women who had gestational diabetes or preeclampsia or gestational hypertension during pregnancy were omitted. Data were collected with a survey.

 The result found 34.1%, 33.1%, 23.8%, and 9% were categorized as having inadequate, problematic, sufficient, and excellent maternal HL. Women with sufficient and excellent literacy were meaningfully better in having earlier and more frequent antenatal care, earlier folic acid consumption, and exercise before and during pregnancy, pregnancy alarm sign awareness, neonatal birth weight, and breastfeeding.

The results proposed that sufficient and excellent HL among women is related to good pregnancy outcomes and poor HL causes a poor chance to gain a positive pregnancy outcome. A cooperative work to grow maternal HL by considering HL levels, revision of educational materials into plain language, and provision of pregnant women with verbal and video instruction in addition to written materials are highly recommended.

 The thymus gland significantly affects fetal immune system maturation. Additionally, there is a linear association between thymus gland size and its performance. Given the high prevalence of vitamin D deficiency in Iran and scarce studies with conflicting results, subjecting maternal vitamin D concentration effect on fetal thymus, we decided to investigate maternal vitamin D concentration and its relation to fetal thymus size in mid-gestation. This study also aimed to generate a race-specific reference range.

We performed a cross-sectional study of ultrasound measurements of the fetal thymus at 18-22 weeks of gestational age in 94 pregnant women and its correlation with maternal serum vitamin D levels from May to July 2021 at the tertiary center of Imam Khomeini Hospital in Tehran, Iran.

The mean values of thymus perimeter, thymus-thoracic ratio, thymus transverse diameter, and thymus area in all participants were 4.18±0.56 cm, 0.37±0.04, 1.56±0.21 cm, and 1.11±0.76 cm2, respectively. There was a trend toward decreased thymus perimeter and transverse thymus diameter with decreasing level of maternal vitamin D. There was also a significant correlation between thymus perimeter and transverse thymus diameter with fetal biometric indices and gestational age. Furthermore, a significant correlation was observed between the thymus perimeter and transverse thymus diameter.

We generated a race-specific nomogram for fetal thymus size in Iranian pregnant women. Moreover, the observed trend toward decreased fetal thymus size with decreasing maternal vitamin D levels requires further prospective investigations. A high prevalence of vitamin D deficiency and low compliance with daily vitamin D intake during pregnancy was also shown, which requires a solution.

Salmonella spp. and Campylobacter can be transmitted through raw milk and cause foodborne illness. The aim of this study was to investigate the prevalence of Campylobacter and pathogenic species of Salmonella spp. species in raw cow's milk using molecular method in Mazandaran province. 100 samples of raw milk were randomly collected from traditional milk collection and retail centers in Mazandaran province in 2019. All samples were transferred as soon as possible to the microbiology laboratory of the Faculty of Veterinary Medicine, Amol University of Special Modern Technologies, in sterile containers and in suitable cold chain conditions. DNA was extracted from milk samples using a commercial kit and then the polymerase chain reaction was performed using appropriate primers to identify Campylobacter jejuni, Campylobacter coli and Salmonella. Out of 100 samples, 7 samples (7%) were infected with Campylobacter jejuni, no positive sample of Campylobacter coli was observed and 2 samples (2%) were infected with Salmonella. According to the results of the present study and the presence of the mentioned bacteria in milk, it is necessary to observe the hygienic principles in the dairy industry, processing and use of sufficient heat to eliminate the mentioned bacteria in raw milk and also use fast and accurate methods to identify These bacteria.

Plant essential oils are used as natural preservatives due to their antimicrobial and antioxidant properties. The aim of this study was to investigate the chemical composition, antioxidant and antimicrobial properties of Perovskia abrotanoides Kar essential oil (PAEO) nanoemulsion.

The chemical composition of the essential oil was determined by gas chromatography apparatus connected to a mass spectrometer. The antioxidant properties PAEO essential oil by DPPH method and its antibacterial effect on Aeromonas hydrophila, Bacillus cereus, Escherichia coli, Listeria monocytogenes, Salmonella Typhimurium and Stylococcus aureus were determined by broth microdilution, agar well diffusion and disk diffusion methods.

In the chemical analysis of PAEO, 21 compounds were identified, of which eucalyptol and camphor and a-pinene were the major constituents. The IC50 of PAEO was 46.44 mg / ml. Among the studied bacteria, Escherichia coli and Listeria monocytogenes showed the highest sensitivity (MIC=0.03%) and Staphylococcus aureus showed the lowest sensitivity (MIC=0.2%) to PAEO nanoemulsion. The bacterial growth inhibition zone in disk diffusion method in the studied concentrations, from 7.06±0.60 to 58.43±1.40 mm and in the agar well diffusion method between 6.56±0.60 to 54.93±1.10 mm was variable.

PAEO Nanoemulsion can be used in the food industry despite its phenolic and camphor compounds as a natural antioxidant and antimicrobial compound.

Urinary tract infection is one of the most common bacterial infections in the world and Europathogenic Escherichia coli is one of the main causes of this infection. The presence of fimbrial genes causes the bacteria to attach to the cells of the urinary tract. The aim of the present study was to evaluate the presence of 3 fimbrial genes papEF, sfaD, and fimH in Escherichia coli isolated from patients with urinary tract infections.

In the current cross-sectional study, 235 urine samples were randomly collected from patients referred to different laboratories in Amol between 2018-2019. First, each sample was cultured separately on EMB agar and then analyzed using biochemical tests, such as IMViC, TSI, and urease. In positive samples for the presence of Escherichia coli, antibiogram test was performed to evaluate the sensitivity to the imipenem. After DNA extraction from imipenem resistant samples via boiling method, the presence of papEF, sfaD, and fimH genes was examined using Polymerase Chain Reaction (PCR). The results of the study were analyzed in SPSS, version 22. Statistical analyses were performed running Man-Whitney and Chi-square tests with a significance level of P<0.05.

From among the 235 urine samples, 75 (31/9%) contained Escherichia coli bacteria. Also, 47 samples (62/7%) were detected from imipenem-resistant Escherichia coli isolates. After PCR reaction, it was found that 28 isolates (59/6%) were positive for fimH gene, 8 isolates (17%) were positive for papEF gene, and 19 isolates (40/42%) were positive for sfaD gene. The results showed that, among the studied strains, fimH gene was the most common gene encoding fimbriae in Escherichia coli isolated from urinary tract infection in Amol city. However, this finding was not statistically significant (P <0.05). Also, in the statistical study of the results of antibiotic resistance and the presence of fimbrial virulence genes, no significant relationship was observed between the variables (P <0.05).

It seems that fimH gene is the most common gene encoding fimbrial in Escherichia coli isolated from urinary tract infections in Amol city and is an important factor in the pathogenicity of this bacteria. Most cases of urinary tract infections are associated with Escherichia coli bacteria that contain these genes, so its early detection in patients with urinary tract infections can help treat patients in a faster and better way.

Context:

 Recently, a new coronavirus (SARS-CoV-2) as the cause of COVID-19 has made a global health crisis and a great challenge. Pregnant women and fetuses are among the high-risk groups for COVID-19. In this review, we summarize studies regarding SARS-CoV-2 virus-placenta interactions at the maternal-fetal interface by demonstrating the pathogenicity of the virus and defense methods of the placenta.

Evidence Acquisition:

 In the present study, a search was done in domestic and international databases including Google Scholar, Web of Science, PubMed, and Scopus using specific keywords (“Coronavirus” OR “COVID-19” OR “SARS-CoV-2”) AND (“Fetus” OR “Placenta”) AND (“Pregnancy”), limited until August 2020. Finally, we reviewed 250 articles.

 Generally, the pathogenicity and the life cycle of SARS-CoV-2 and virus entry and replication methods allow the virus to pass through the placenta, although there are hormonal and immune barriers in the placenta against SARS-CoV-2, such as placental type interferons.

 The SARS-CoV-2 can pass through the placenta, but there are defense methods against it.

Immunoglobulin G is the most abundant immunoglobulin in human blood, comprising approximately 75% of serum antibodies. Human IgG is a glycoprotein and can be an antigen for other mammals. Antibody-sensitized red blood cells (RBCs) and complement components can react with anti-human globulins resulting in their agglutination. This study aimed to prepare an antiserum against human IgG for deploying in Coombs Wright and cross-match for rare blood groups.

After isolation of serum from healthy blood donors, serum proteins were precipitated using ammonium sulfate. Consequently, tangential flow filtration and ion-exchange chromatography were applied to purify IgG. SDS-PAGE and Bradford protein content assay was conducted to evaluate the quality and the concentration of the purified IgG.  Rabbits were weekly injected with different amounts of the protein four times. Then, sera were obtained from the immunized mice, and total IgG was purified.  Finally, the Coombs Wright test was performed on samples from brucellosis patients to validate purified IgG antibody quality.

Electrophoresis and Bradford assay results showed that the purified protein had considerable high purity and quantity. Protein bands of reducing and the non-reducing SDS-PAGE showed high purity of the protein along with a protein yield of 2.2 mg/L. Coombs Wright tests using the rabbit anti-human serum had a comparable result with available commercial anti-human immunoglobulin.

The results indicated that our method for the purification of IgG was suitable for anti-human globulin preparation. This antibody can also be used in clinical diagnostic tests such as Coombs Wright, cross-match, and blood types evaluation with weak Rh or Du antigens.

Antibodies are important agents in the laboratory diagnosis of various microorganisms such as Streptococcus pneumoniae. In this study, we prepared and purified IgG antibody against Streptococcus pneumoniae using novel methods to be used in ELISA and agglutination diagnostic kits. First, Streptococcus pneumoniae was cultured, harvested, and inactivated. Then, bacteria were injected into four mature New Zealand white rabbits, and antisera were developed. Afterward, immunoglobulins were purified using ammonium sulfate precipitation, diafilteration using Tangential Flow Filtration, and ion-exchange chromatography. The purified antibody was then biotinylated and used in ELISA. Gel electrophoresis results showed that the antibody was highly pure. Agglutination test on the primary antigen and clinical samples was four-plus. ELISA results showed that the sensitivity and specificity of the test were 95% and 100%, respectively. Results indicated that our fast method was suitable for anti-Streptococcus pneumoniae IgG purification. Repetitive qualitative and quantitative experiments confirmed high purity of the immunoglobulin. Thus, it could be a suitable candidate to be used in laboratory diagnostic kits.

 Predicting preterm delivery can help obstetricians and midwives for better management of pregnancy care. Therefore, we aimed to investigate the relationship between cervical length and uteroservical angle with the occurrence of preterm delivery.

The present cohort study was conducted on 100 pregnant women with singleton pregnancy referred for routine control to perinatology ward of Imam Khomeini Hospital in Tehran between Jan 2019-Apr, 2019. All included cases were undergoing transvaginal sonography to measure the anterior cervical angle and length. Maternal demographic and clinical data, as well as delivery data of pregnant women, were obtained from their medical records. Logistic regression was conducted to estimate the predictors of pre-term delivery. All analyses were performed using Stata 14.0.

Among 100 pregnant women, 17 had preterm delivery. Pregnant women with bleeding during pregnancy were reported with a higher preterm delivery rate (23.53% vs. 4.82%) (P=0.01). The difference of mean cervical angle between pregnant women with the term and preterm delivery was statistically different (102.12° in women who delivered pre-term vs. 86.15° in term group, P<0.001).

According to the results, pregnant women with bleeding during pregnancy and those with a higher mean of cervical angle were more prone to pre-term delivery. Therefore, the anterior cervical angle and bleeding during pregnancy can be considered as predictors for preterm birth.

Lack of job motivation is the most important cause of reduced quality of professional performance. Field evidence indicates a dramatic reduction in teacher’s motivation. This study aims to represent the teachers’ perceptions and lived experiences about the causes of teachers’ motivation reduction. By using a qualitative approach and a descriptive phenomenological method, an effort has been made to reconstruct teachers’ perceptions of the causes of loss of motivation. Semi-structured interviews were used to collect data. Having used purposeful sampling and chain sampling, and through 20 interviews with teachers, data saturation was achieved. Deep analysis of the teachers’ lived experiences led to the identification and classification of the five major categories of motivation reduction factors. These five factors are: “educational issues”; “internal organizational issues”; “economic issues”; “social issues”; and “personal and family issues.The Results showed that each teacher faces many different challenges in the field of education and professional activities, and lack of attention to improving their status can lead to a major risk in the educational system and in particular the dynamism and development of the society in the near future.

Cervix insufficiency is diagnosed based on a previous history of pregnancy loss in the second trimester, followed by painless cervical dilatation or premature rupture of the fetal membranes. Abnormal cervical tissue structural appears to be the cause of this complication. There are no diagnostic methods for cervical insufficiency before pregnancy, but magnetic resonance imaging (MRI), hysterosalpingography, and ultrasound can detect uterine anomalies that are risk factors for cervical insufficiency. Cerclage is known as a common procedure for prevention of the preterm labor, caused by cervix insufficiency. This study aimed to evaluate the prevalence of cerclage and it’s complications and prognosis based on the patient’s age, history of cervical insufficiency, history of preterm labor, history of miscarriage, curettage, and cervical and vaginal abnormalities.

A retrospective cohort study was conducted, including 65 patients, from March 2012 to March 2018, in Valiasr Hospital, Tehran, Iran. Data including the age, history of cervical insufficiency, history of abortion, history of cervix surgery and curettage, gestational age, presence of vaginal and cervical anomaly as well as complications such as bleeding and severe cervical pain and prognosis of cerclage were extracted.

In our study, 65 women who undergone cerclage were evaluated, the mean age of the participants was 28.4 years. Abortion was present in 27.7% of cases, 16.9% once, 7.7% twice and 3.1% three times. In 21.5% of cases, there was a history of curettage and 66.2% had a history of preterm labor. For 4.6% of the subjects, the length of cervix was under 10 mm. Gestational age at the end of cerclage was under 26 weeks in 5.8% of patients. The termination of pregnancy was higher in patients with lower gravida, and the termination of pregnancy was significantly higher in those who were not curetted (P= 0.001). There were no complications, and the prognosis is considered good, in case the termination is above 32 weeks. The birth weight mean was 3041.5 grams. According to our study, the failure of the cerclage is associated with previous history of dilation and curettage (D&C) and higher gravidity.

Putting all the results together, 80% of the cerclage, performed in our institution were successful, without any complications.

Due to increased rate of risk factors, the incidence of placenta accreta (PA) is increasing worldwide. This study aimed to investigate the important factors regarding the occurrence of PA, as well as outcomes and complications of Trans Abdominal Hysterectomy (TAH) in the patients with PA.

The study was performed as an observational cross-sectional study.  Between March 2011 and March 2017, 177 patients, known cases of PA that undergone TAH, were enrolled in our study. Extracted data include demographic characteristics, patient’s medical history, surgical approach and complications, such as blood loss and urologic problems.

The average of maternal age and gestational age were 33.6±4.70 (range= 22-43) years and 34.6±3.16 weeks, respectively. Neither maternal age (P=0.652) nor BMI (P=0.659) had significant association with abnormal placentation. Previous history of dilation & curettage (D&C) was found in 34 patients that was not related to the occurrence of the PA (P=0.508).Twenty-one (11.9%) of the patients needed urological intervention that did not associated with placental position, skin and uterine incision (P=0.258, 0.410 and 0.219). There is no relation between amount of blood loss with gestational age (P=0.7) and number of C/S (P=0.4), gestational age (P=0.7), anesthesia (P=0.2), and curettage history (P=0.3).

 Our mortality and morbidity rate is much lower than reported ones, indicating the high-level ability, skill and knowledge of the surgeons.

A professional vision at education is necessary, because of the increasing development of technical education in the field of medical education. In the conventional methods, although mastering in the field and being up-to-date is necessary, today, the faculty member must be able to design and implement a group of learning experiences for the students in order to learn and to conduct valid exams. Our study was an interventional study, conducted on obstetrics and gynecology residents of the 3rd and 4th year at Tehran University of Medical Sciences in March, 2016. The number of participants was 66. The data collection was performed by a questionnaire. The included 19 questions about the anatomy of pelvic floor. At first, the questionnaires were administered to pre-test students to assess the amount of information before and then the theoretical and practical class about the anatomy of pelvic floor were held. At the end of classes, pre-test questionnaires were returned to residents. The responses to questions before and after the training were analyzed. Our study was conducted on 66 obstetrics and gynecology residents. Of the 66 subjects, 30 were in the pre-test and 66 were in the post-test. The mean score of residences in the anatomy of the pelvic floor before intervention was 5.388±7.14 and after intervention was 12.57±2.181 (P=0.001). The difference in mean before and after education was significant at all levels of study. The general knowledge scores in the post-test, was significantly (P<0.05) higher than pre-test. According to our findings, it can be stated that the implementation of scholarship project regarding the knowledge of obstetrics and gynecology residences by the method of theoretical and anatomical teaching of anatomy of pelvic floor increases their knowledge, consequently, increase ability of surgical procedures of the residents and reduce complications. It is recommended that other education centers use a similar method to educate obstetrics and gynecology residents.