Comparison of posttraumatic growth and posttraumatic stress of nurses with physicians and medical students after caring of COVID‑19 patients

Objectives:The present study compared the prevalence and psychosocial factors affecting posttraumatic growth(PTG),posttraumatic stress disorder(PTSD),and psychological distress in nurses,physicians,and medical students.Materials and Methods:In a cross‑sectional study,three groups of medical staff including nurses(n=57),physicians(n=40),and medical students(n=34)who were responsible for the care/treatment of COVID‑19 patients admitted to a general hospital for 4 months responded to Posttraumatic Growth Inventory,Brief Symptom Inventory‑18,Resilience Questionnaire,PTSD Screen,and Social Capital‑Integrated Questionnaire.Results:After the exposure of medical staff to at least 4 months of treatment/care of COVID‑19 patients,PTG prevalence was higher than PTSD(38.2%vs.14.6%),but they experienced some degrees of psychological distress(65.5%).The nurses had 8.33(confidence interval[CI]:2.5–26.7)times higher PTG rate than medical students(P<0.001).Physicists also experienced 5.00(CI:1.4–26.7)times higher PTG than medical students(P<0.001).PTG was aided by age,married status,strong resilience,and high social capital,but gender had no influence.Resilience played an important protective role to prevent the incidence of psychological distress in nurses,medical students,and physicians.Conclusion:Despite the fact that the PTSD and psychological distress were same in the three groups of medical staff,the nurses had a greater rate of PTG than physicians and medical students.

Antimicrobial resistance pattern in ventilator-associated pneumonia in an intensive care unit of Babol, northern Iran

Objective:To investigate antibiotic resistance pattern of ventilator-assiated pneumonia (VAP) generating microorganisms,and quantitative culture and determining antibiotic sensitivity.Methods:This cross sectional study was performed on 50 patients suffering from VAP in intensive care unit of Ayatollah Rouhani Hospital,Babol,Iran during 2014-2015.VAP was probable for them based on clinical signs and the criteria of Clinical Pulmonary Infection Score standards.Lower respiratory samples were given under bronchoalveolar lavage and quantitative culture was done on them.Afterwards by microdilution method,minimal inhibitory concentration based on respective microorganisms,considering clinical pulmonary infection score were determined.Results:From 50 investigated samples in this study,the most common microorganisms were Acinetobacter baumannii (A.baumannii) (70%) then Pseudomonas aeruginosa (12%),Staphylococcus aureus (8%) and Klebsiella pneumonia (3%).In our study A.baummannii showed approximate 100% resistance to all antibiotics,in a way that A.baumannii resistance to imipenem and meropenem and piperacillin/tazobactam each was 97.1%.The most resistance of Pseudomonas aeruginosa was 66.7% to each cefepime and ceftazidime and clavulanate/ticarcillin.Staphylococcus aureus showed 75% resistance to nafcillin,cloxacillin and resistance in case of vancomycin was not seen.Conclusion:In current study,A.baumannii had the most prevalence among VAP and this species is resistant to most of antibiotics.Using ceftazidime,cefepime and clavulanate/ticarcillin,in treatment of the patients suffering VAP is not reasonable.

Osteoarticular manifestations of human brucellosis:A review

Brucellosis is a common global zoonotic disease, which is responsible for a range of clinical manifestations. Fever, sweating and musculoskeletal pains are observed in most patients. The most frequent complication of brucellosis is osteoarticular involvement, with 10% to 85% of patients affected. The sacroiliac(up to 80%) and spinal joints(up to 54%) are the most common affected sites.Spondylitis and spondylodiscitis are the most frequent complications of brucellar spinal involvement. Peripheral arthritis, osteomyelitis, discitis, bursitis and tenosynovitis are other osteoarticular manifestations, but with a lower prevalence. Spinal brucellosis has two forms: focal and diffuse. Epidural abscess is a rare complication of spinal brucellosis but can lead to permanent neurological deficits or even death if not treated promptly. Spondylodiscitis is the most severe form of osteoarticular involvement by brucellosis, and can have single-or multifocal involvement. Early and appropriate diagnosis and treatment of the disease is important in order to have a successful management of the patients with osteoarticular brucellosis. Brucellosis should be considered as a differential diagnosis for sciatic and back pain, especially in endemic regions. Patients with septic arthritis living in endemic areas also need to be evaluated in terms of brucellosis. Physical examination, laboratory tests and imaging techniques are needed to diagnose the disease. Radiography, computed tomography, magnetic resonance imaging(MRI) and bone scintigraphy are imaging techniques for the diagnosis of osteoarticular brucellosis. MRI is helpful to differentiate between pyogenic spondylitis and brucellar spondylitis. Drug medications(antibiotics)and surgery are the only two options for the treatment and cure of osteoarticular brucellosis.

Resistance of Helicobacter pylori to furazolidone and levofloxacin: A viewpoint

In their review, Arslan et al[1] did not describe the status of Helicobacter pylori(H. pylori) treatment with furazolidone and the resistance to this antibiotic. We have presented different surveys showing the resistance of H. pylori to furazolidone from Asia and South America. The resistance rates varied but were mostly low(< 5%). There are not enough data on its efficacy and resistance in the United States and Europe. H. pylori mutations occurring in the oor D gene, including A041 G, A122 G, C349A(G), A78 G, A112 G, A335 G, C156 T and C165 T, and in the por D gene, including G353 A, A356 G, C357 T, C347 T, C347 G and C346 A, have been indicated to be possibly related to the observed resistance. Additionally, to complete Arslan et al 's statement regarding levofloxacin resistance, it should be noted that compound mutations of N87 A, A88 N and V65 I at codon Asn-87 were recently observed in the gyr A gene for the first time. However, the results on these topics are not sufficient, and more worldwide studies are suggested.

Single-and double-dose of platelet-rich plasma versus hyaluronic acid for treatment of knee osteoarthritis: A randomized controlled trial

BACKGROUND Platelet-rich plasma(PRP)and hyaluronic acid have been shown to be useful in the treatment of knee osteoarthritis.However,investigations comparing the efficacy of these two drugs together are insufficient.AIM To compare the outcomes of PRP vs hyaluronic acid injections in three groups of patients with bilateral knee osteoarthritis.METHODS This randomized controlled trial study involved 95 patients.Thirty-one subjects received a single injection of PRP(group PRP-1),33 subjects received two injections of PRP at an interval of 3 wk(group PRP-2)and 31 subjects received three injections of hyaluronic acid at 1-wk intervals(group hyaluronic acid).The patients were investigated prospectively at the enrollment and at 4-,8-and 12-wk follow-up with the Western Ontario and McMaster Universities Arthritis Index(WOMAC)and Visual Analogue Scale questionnaires.RESULTS Percentages of patients experiencing at least a 30%decrease in the total score for the WOMAC pain subscale from baseline to wk 12 of the intervention were 86%,100%and 0%in the groups PRP-1,PRP-2 and hyaluronic acid,respectively(P<0.001).The mean total WOMAC scores for groups PRP-1,PRP-2 and hyaluronic acid at baseline were 63.71,61.57 and 63.11,respectively.The WOMAC scores were significantly improved at final follow-up to 42.5,35.32 and 57.26,respectively.The highest efficacy of PRP was observed in both groups at wk 4 with about 50%decrease in the symptoms compared with about 25%decrease for hyaluronic acid.Group PRP-2 had higher efficacy than group PRP-1.No major adverse effects were found during the study.CONCLUSION PRP is a safe and efficient therapeutic option for treatment of knee osteoarthritis.It was demonstrated to be significantly better than hyaluronic acid.We also found that the efficacy of PRP increases after multiple injections.

Isolation of Stenotrophomonas maltophilia from clinical samples: An investigation of patterns motility and production of melanin pigment

Objectives: To investigate possible sources of Stenotrophomonas maltophilia(S. maltophilia) in the clinical environment.Methods: Different samples were collected from Amol City of Iran. Steps for the identification of S. maltophilia included culturing, biochemical tests, polymerase chain reaction(PCR) of 16 S r RNA gene and 23 S r RNA gene. In addition, production of melanin pigment and patterns of motility of the bacteria, were also investigated.Results: In our study, 20 S. maltophilia strains were isolated from clinical sources,oxygen manometer apparatus of hospitals were 7/110(6.36%), blood was 1/777(0.13%),sputum was 4/40(4%), urine was 1/2 947(0.03%), tap water was 1/240(0.42%) and dental suction was 6/120(5%). The isolated bacteria showed production of melanin pigment with rates of strong, moderate, weak, and lack of pigment. Types of motilities were seen in isolates.Conclusions: The highest percentage of bacteria is isolated of oxygen manometer system and dental suction, yet has not been reported from oxygen manometer system. These bacteria have also been associated with patients who have respiratory problems, so it is essential for staffs of hospitals to draw attention to this source of bacteria.

Design of a multiplex PCR method for detection of toxigenicpathogenic in Vibrio cholerae

Objective:To study virulence and regulatory genes(hlyA,ctxB,tcpI) in clinical strains of Vibrio ckolerae(V.cholerae),simultaneously.Methods:Three important genes,tepI,hlyA and ctxB were used for detection of toxigenic and pathogenic V.cholera by chain reaction assay method. Results:According to the results of the PCR,the incidence of hlyA,tcpI,and ctxB genes in clinical isolates was obtained as 94.7%(72 sample),90.8%(69 sample),and 92.1%(70 sample), respectively.Five strains possessed all genes except ctxB,six strains possessed all genes except tcpI,four strains possessed all genes except hlyA,one strain possessed only hlyA and 60 strains contained a combination of three genes.Including hlyA,ctxB and tcpI,Conclusions:Result show that this method could be reliable to detect toxigenic-pathogenic strains of V.cholerae in Iran.

A Survey of Correlation Infertility Self-Efficacy with Behavioral Health Scales in Infertile Women

Background: Infertility is a unique medical challenge that can have health behavioral consequence on infertile women including lack of self-esteem, depression, anxiety, fertility problem in infertile couples. The aim of this study was to evaluate correlation between self-efficacy and health behaviors scales in infertile women. Methods: A cross sectional study was conducted on 89 infertile women with mild to moderate depression (Beck scores 10 - 47) who were recruited from Fatemeh Zahra Infertility and Reproductive Health Research Center. All participants completed Self-efficacy Inventory (ISE) and other health behavioral scales (e.g., the Beck Depression Inventory (BDI), Cattle Anxiety Scale (CAS), Fertility Problem Infertility (FPI), and GHQ). Pearson correlation coefficient and Spearman rho correlation coefficient were used to analyze the data. Variables were included in the study if they had a p-value

Effect of perineal massage on the incidence of episiotomy and perineal laceration

Background: Perineal traumas particularly caused by following vaginal delivery are associated with short and long term morbidity for women. Therefore, interventions that increase the probability of intact perineum are necessary. The aim of study was to determine the effect of perineal massage with a sterile lubricant on the incidence of episiotomy and perinea laceration. Materials: This clinical trial study was performed on 145 nulliparous women who referred to Amol Emam Ali teaching center for normal delivery. They were randomly participating in interventional group (massage with lubricant) (45 cases) or control group (100 cases). In massage group when they progressed to full dilatation of the cervix, the midwife inserted two fingers inside vagina and using a sweeping motion gently stretched the perineum with lubricant 5 up to 10 minutes, in and between mother’s pushing in the second stage of labour. In control group just Ritgen Maneuver was applied. At last, we compared the rate of intact perineum, episiotomy and laceration, mean duration of the second stage of labor and Apgar score in 1 and 5 minutes between two groups. Statistical analyses were performed using t-test, Chi Square to determine potentially significant associations, and a p value less than 0.05 was considered significant. Results: The incidences of intact perineum, episiotomy and laceration were 22.2% (10), 44.4% (20), 33.3% (15) respectively in interventional group. In control group, intact perineum, episiotomy and laceration were: 20.2% (20), 49.3% (71), 28.3% (28) respectively. This difference was not statis- tically significant. Rate of first-degree laceration was 33.3% (15) in massage group, while this percent was 28.3% (28) in control group. This difference was not statistically significant. In massage and control groups, second, third and fourth-degree lacerations did not occur. Conclusion: The results showed that massage with a sterile lubricant provides no apparent and significant advantage or disadvantage in reducing perineal trauma. Therefore, the use of massage as technique for perineal control is safe based on labour criteria and woman’s preference during delivery.

Nanofibrous nerve conduits for repair of 30-mm-long sciatic nerve defects

It has been confirmed that nanofibrous poly（3-hydroxybutyrate-co-3-hydroxyvalerate） nerve conduit can promote peripheral nerve regeneration in rats. However, its efficiency in repair of over 30-mm-long sciatic nerve defects needs to be assessed. In this study, we used a nanofibrous poly（3-hydroxybutyrate-co-3-hydroxyvalerate） nerve conduit to bridge a 30-mm-long gap in the rat sciatic nerve. At 4 months after nerve conduit implantation, regenerated nerves were macroscopi- cally observed and histologically assessed. In the nanofibrous graft, the rat sciatic nerve trunk had been reconstructed by restoration of nerve continuity and formation of myelinated nerve fiber. There were Schwann cells and glial cells in the regenerated nerves. Masson＇s trichrome staining showed that there were no pathological changes in the size and structure of gastrocnemius muscle cells on the operated side of rats. These findings suggest that nanofibrous poly（3-hydroxybutyrate-co-3- hydroxyvalerate） nerve conduit is suitable for repair of long-segment sciatic nerve defects.

Protoscolicidal and immunomodulatory activity of Ziziphora tenuior extract and its fractions

Objective:To evaluate the scolicidal and immunomodulatory effect of the Ziziphora tenuior(Z.tenuior) extract and its fractions.Methods:Protoscolices were treated with six concentrations(3,5,10,25,50,and 100 mg/mL) of Z.tenuior extract and its fractions(ethanol,petroleum ether,ethyl acetate and chloroform) in periods of 10,20,30,40,50 and 60 minutes,and viability of protoscolices was evaluated using the 1.0%eosin.To examine the immunomodulatory effects of Ziziphora and its fractions on macrophage cells,the non-toxic concentration of extract and different fractions determined by MTT assay,and the Griess reaction was used to measure the level of nitrite as an indicator of nitric oxide by the macrophage cells in 10,100 and 200 μg/mL in 24 hours at 37 ℃.Results:In this study,the Z.tenuior extract at 10 mg/mL concentration was able to kill all protoscolices during 20 minutes.By increasing the concentration to 25 mg/mL,the scolicidal time reduced to 10 minutes.Regarding the effect of different fractions of Z.tenuior,the ethanolic fraction showed the highest scolicidal activity.The extract demonstrated an inhibitory effect on the activity of macrophages and reduced nitric oxide production.Although the petroleum ether and ethanolic fractions of the extract reduced nitric oxide production,nevertheless,this effect was only significant at 10 and 100 ug/mL concentrations(P<0.05).Conclusion:The Z.tenuior extract and its fractions were effective against protoscolices yet the effect of total extract was considerable.Our findings indicates that the extract and its ethanolic and petroleum ether fractions could have anti-inflammatory properties.

Epidemiological status of malaria in Iran,2011-2014

Objective:To determine the status and epidemiological aspects of malaria in Iran in favor of gaining a better understanding of the national control of malaria.Methods:This epidemiological study examined the status of malaria from 2011 to 2014 in Iran.Data were collected from the Ministry of Health's protocol for controlling and eliminating malaria,which is currently in use.This malaria information reporting system is automated in all Iranian provinces and cities,and all information is submitted online to the center for communicable disease control in the Ministry of Health.Information about malaria is available for researchers to evaluate.Results:The incidence rates decreased from 2011 to 2014.There were 4.76,2.12,1.80,and 1.59 per 100 000 people,respectively from 2011 to 2014.During the four-year period(2011-2014),the highest numbers of cases occurred in those aged 16-25 years,by age,and in men,by sex.Most of the cases were workers and located in rural areas.An average 52.58%of cases were Iranian.The highest incidence rates from 2011 to 2014 were located in Sistan and Baluchestan province.There were 89.94,43.9,38.3,and 30.66 per 100 000 people.The highest numbers of malaria cases were recorded in the cities Sarbaz,Nickshahr,and Chabahar in Sistan and Baluchestan province and Bandar Abbas,Bandar Jask,and Bandar Lengeh in Hormozgan province.During the four-year period,57.05%of cases were caused by imported factors.The majority of cases were related to the trophozoite lifecycle of parasites.Regarding surveillance,there was inactive care in the majority of cases.Vivax malaria was the most prevalent.Conclusions:Despite the recendy declining trend in reported cases,the expansion of local transmission,especially in areas with cross-border travel,is very worrying.Improved malaria control interventions can be effective for elimination of malaria in Iran;these can include programs to control border travel and focused interventions for high incidence areas and high-risk groups such as rural residents,men,workers,and people < 35 years old.

Clinical Findings of Patients Undergone Surgery for Testicular Torsion: A 12-Year Single Center Experience in Northern Iran

Introduction: Testicular torsion is a surgical emergency which requires early diagnosis and prompt surgical management to avoid testicular damage. The aim of this study is to survey the clinical findings and outcome of the patients treated for testicular torsion in a university hospital in Babol, northern Iran. Methods: In this cross sectional study, a retrospective survey of all cases presenting with acute scrotum and primarily diagnosed as testicular torsion was conducted during 2001 and 2012 in Babol, northern Iran. All 103 cases were reviewed and several clinical data, including duration of symptoms and operative findings were collected. Findings: Of 103 patients who presented to the emergency department with acute scrotum, the median age of the cases was 16.0 years. Thirty four percent of the patients presented emergency unit less than 6 hours from symptom exposure. Pain (95.1%) was the major symptom in all patients. Surgery revealed that 72 (70.9%) cases were diagnosed firmly as testicular torsion that 23 patients underwent orchidectomy for a necrotic torsed testis. There were significant differences between orchiectomized versus non-orchiectomized torsion cases in affected side, symptom presentation to operation time. Conclusion: According to our results more than half of the cases presented more than in the golden time. Late presentation to hospital was the major cause of delay leading to orchidectomy in patients with testicular torsion. Greater effort in health education and direct or selfreferal to hospital may reduce this delay.

Is coping strategies predictor of anxiety and depression in couple infertile?

Background: Infertility is a complex crisis of life and increases psychological difficulties such as anxiety and depression. Identification of copy strategies for stressful events like infertility is important. The aim of our study was to investigate the relationship between coping strategies with anxiety and depression symptoms in men and women’s infertile. Methods: This descriptive-analytic study was conducted from 2011-2012 on 168 Iranian infertile couples referred to the Fatemeh Zahra infertility and reproductive health research center of Babol university of medical science to initiate assistant reproductive technologies and completed the Ways of Coping Questionnaire (WCQ), The State-Trait Anxiety Inventory (STAI), and Beck Depression Inventory (BDI).The results were analyzed using t-test, the Pearson correlation and the stepwise model of multiple regression analysis. P Results: Escape/ avoidance contributed the greatest amount of unique variance to the model for anxiety/de-pression of infertile women (P < 0.0001, P < 0.001) and followed by distancing (P < 0.0001, P < 0.01), accepting responsibility(P < 0.0001, P < 0.01). Seeking social support was the negative significantly predictor for both anxiety and depression in infertile women (P < 0.01, P < 0.01), but planful problem solving was the inversely predictor for only depression in infertile women (P < 0.01). Escape/avoidance was the only predictor factor of the model anxiety for infertile men (P < 0.01). Escape/avoidance and self controlling were the positive predictor (P < 0.001) and planful problem solving was the negative predictor for men depression (P Conclusion: men and women infertile who use disproportionally maladaptive coping strategies such as escape/avoidance are predisposed to anxiety and depression symptoms. How using the coping strategies is very important in expressing anxiety and depression in infertile couples and training the adaptive coping strategies suggested by counseling centers.

A Study on the Microbial Quality of Drinking Water in Rural Areas of Mazandaran Province in North of Iran (2011)

Backgrounds: One of the fundamental needs of a community is to have an access to healthy and safe drinking water. The lack of a concentrated accessibility to health facilities and services is among the serious problems facing villagers in the rural areas. The aims of this research was to investigate the drinking water quality of the villages in Babol township suburbs in north of Iran. Materials and Methods: In this cross-sectional descriptive study, a total of 140 water samples were taken from the water distribution network in16 villages for the low and high-rain seasons in sterile glass bottle. The microbial quality of gathered samples were determined based on standard methods in laboratory. Statistical analysis of the results was performed using a SPSS16 statistical software. Findings: Based on obtained results 13.6% of the samples were contaminated to coliform and 20% to fecal coliform bacteria. The residual chlorine in 12.5% of the samples were between 0.2 to 0.8 mg·L-1 and the PH in total samples were between 6.8 to 7.8. There were no signs of any contamination for 32.86% of the analysed samples which water resources is located to a distance of more than 30 m to the contamination sources. In addition, 43.1% of the samples taken from the water resources with no plumbing system, have had a fecal contamination. Conclusions: Considering the results achieved, the microbial quality of the drinking water of the studied villages classified as “moderate” status. For more water supply there is not sufficient residual chlorine in most cases. Poor sanitation of water supply is most causes of water contamination. It is therefore strongly recommended that sanitation measures are made to protect water resources from the contamination.

Hyaluronic acid algorithm-based models for assessment of liver fibrosis： translation from basic science to clinical application

BACKGROUND： The estimation of liver fibrosis is usually dependent on liver biopsy evaluation. Because of its disadvantages and side effects, researchers try to find non-invasive methods for the assessment of liver injuries. Hyaluronic acid has been proposed as an index for scoring the severity of fibrosis, alone or in algorithm models. The algorithm model in which hyaluronic acid was used as a major constituent was more reliable and accurate in diagnosis than hyaluronic acid alone. This review described various hyaluronic acid algorithm-based models for assessing liver fibrosis.DATA SOURCE： A Pub Med database search was performed to identify the articles relevant to hyaluronic acid algorithmbased models for estimating liver fibrosis.RESULT： The use of hyaluronic acid in an algorithm model is an extra and valuable tool for assessing liver fibrosis.CONCLUSIONS： Although hyaluronic acid algorithm-based models have good diagnostic power in liver fibrosis assessment, they cannot render the need for liver biopsy obsolete and it is better to use them in parallel with liver biopsy. They can be used when frequent liver biopsy is not possible in situations such as highlighting the efficacy of treatment protocol for liver fibrosis.

Age-specific reference ranges of prostatespecific antigen in the elderly of Amirkola: A population-based study

Objective:To determine the age-specific reference ranges of prostate-specific antigen(PSA)in the older men in the city of Amirkola.Methods:This cross-sectional study is a part of Amirkola Health and Ageing Project(AHAP)which has been conducted as a cohort study since 2011 in Amirkola,a city in northern Iran.The demographic information of all men aged 60 and older were collected through questionnaires and interviews and the PSA measurements were performed using ELISA and Diametra kit.The acquired data were analyzed afterwards.Results:A number of 837 elderly men with a mean age of 69.99±7.72 years participated in this study.The serum PSA level(95th percentile)was determined to be 0.9(0-4.89)ng/mL in the age group of 60-64 years,1.1(0-4.88)ng/mL in the age group of 65-69 years,0.93(0-9.01)ng/mL in the age group of 70-74 years,1.3(0-7.95)ng/mL in the age group of 75-79 years,1.9(0-11.98 ng/mL)in the age group of 80-84 years,and 1.45(0-33.17)ng/mL in the 85 and older group.The serum PSA level was significantly correlated with age(p=0.000).Conclusion:This study indicated that there is a direct correlation between the age and serum PSA levels.The use of age-specific reference range could guide clinicians on the incidence of prostate cancer in this population and perhaps reduce the number of unnecessary tests in this population group.

A case of human acute otoacariasis caused by Rhizoglyphus sp, the first report from Iran

Otoacariasis is the presence of ticks and mites in the auditory canal.A 50-year-old Iranian man was subjected at the an ear,nose,and throat clinic at Rouhani Hospital in Babol with complaint of left ear pain.Otoscopic examination showed mite infestation in the left auditory canal.The infestation was eradicated with the 2% H2O2 solution.Treatment began by applying oral ciprofloxacin (500 mg/day) twice daily for 7 d.We report the rare case of an ear canal infestation with the Rhizoglyphus and their eradication with 2% H2O2 solution.

Unusual form of strongyloidiasis with gastric involvements: A case report

Rationale: Strongyloides stercoralis (S. stercoralis) is an intestinal nematode with a complicated life cycle that can involve the gastrointestinal system. Infected patients are generally asymptomatic;but if symptomatic, the symptoms will include skin rash, respiratory and gastrointestinal symptoms like abdominal pain, diarrhea, nausea and vomiting. Patient concerns: A 77-year old man presented with edema of the lower extremities and insignificant tenderness in the epigastric region. Diagnosis: The histopathology of gastric tissue showed severe inflammation and multiple ulcers in the cardia, antrum and proximal duodenum. A large number of rhabditiform larvae of S. stercoralis along with tissue hyperemia and infiltration of lymphoplasma cells, eosinophils, and neutrophils were found. Intervention: Treatment with albendazole. Outcome: Despite the albendazole treatment, the patient's condition deteriorated and eventually died because of a sepsis-like syndrome. Lesson: Physicians should remain alert to the urgency due to threadworm, especially among the elderly people and immunosuppressed cases;and should ensure accurate diagnosis, suitable treatment and careful follow-up of these cases.

Comparison of Sexual Function in Primiparous Women Pre-Pregnancy and Postpartum: Difference of the Sexual Function after the Normal Vaginal Delivery and the Cesarean Section

Introduction: Sexual function is undoubtedly an important dimension of adult life. Due to all the conflicting results with regard to sexual function after the normal vaginal delivery (NVD) or the Cesarean Section (CS), in the present study, we aimed to compare the sexual function in women pre-pregnancy and postpartum and also after the NVD and CS. Materials and Methods: In this cohort study, two groups of healthy women, with antenatal normal pregnancies, who underwent NVD (n = 90) and CS (n = 113), were prospectively studied. The sexual function of the participants was assessed through a Female Sexual Function Index (FSFI) questionnaire in two stages: once before pregnancy and then within 3 to 6 months after delivery, which lasted from June 2011 to September 2012. The data were analyzed by descriptive and inferential statistics. Data were analyzed using chi-square test, Mann-Whitney test, and T Test. Results: Based on the data gathered from 206 women who completed the FSFI questionnaire in two stages, the mean (±SD) self-reported timing of the resumption of sexual activity was 8.9 ± 1.3. There was no significant statistical difference found between the two groups by timing of the resumption of sexual activity in NVD and CS groups. There was also no statistically significant difference found in the overall sexual function scores between the two groups (NVD vs. CS). The average score for female sexual function in desire, arousal, orgasm, and satisfaction within 3 to 6 months after delivery was significantly lower than that of their pre-pregnancy period (p < 0.004). The mean coitus in postpartum period was 1.84 ± 1.20 per week. Conclusion: Based on the findings of this study, there was no significant relationship between the mode of delivery and changes in sexual function. Therefore, it can be claimed that CS is not preferred to NVD with regard to preserving normal sexual functioning.