فهرست مطالب آمنه منصوری

Caesarean scar pregnancy is rare and delay in diagnosis and treatment is associated with maternal complications, but diagnostic and treatment methods are under investigation due to its rare and there is not standard protocol for manage Caesarean scar pregnancy. The purpose of this case report study is to provide early diagnosis and treatment Caesarean scar pregnancy.

A 34-year-old woman, gravid 2, gestational age of 8 weeks and 3 days, and history of one cesarean section with a complaint of spotting and severe abdominal pain went to the hospital. Beta-human chorionic gonadotropin was reported (β-hCG), 5600 mIU / ml. In a transvaginal ultrasonography of a gestational sac containing internal echoes without embryonic pole was seen in the previous cesarean section and in color doppler of blood flow around the gestational sac. The patient was followed for 3 days the ectopic pregnancy spontaneous abortion or to reduce the size of the gestational sac in the hospital, but dilatation and suction curettage and hysteroscopy resection was performed due to increased β-hCG. Twenty-four hours after treatment, the first β-hCG, 191 mIU / ml was reported, the next evaluation was carried out in two stages with 48-hour intervals and the rate of β-hCG had a decreasing trend. Then, one week later, it was reexamined and the rate of β-hCG was reached to 30 mIU / ml. After eleven days of follow up due to the decrease of β-hCG, the follow-up was stopped.

In the present patient, the caesarean scar pregnancy was diagnosed with transvaginal ultrasonography in the early stages and proper treatment with dilatation and suction curettage and hysteroscopy resection was performed.

Cervical pregnancy is a rare life threatening form of ectopic pregnancy. This is a case report of cervical pregnancy.
Case Report: We describe a case of cervical pregnancy early diagnosed via transvaginal ultrasound and magnetic resonance imaging (MRI). She was treated through curettage, ligation of descending branch of uterine vessels, and tamponade following treatment failure using methotrexate (MTX) due to the patient's refuse to continue treatment; her fertility was preserved, too.
Early diagnosis via vaginal ultrasonography and confirmation of magnetic resonance imaging, and using nonsurgical conservative treatment methods such as methotrexate, ligation of uterine vessels, and cervical tamponade, to preserve the fertility, are the first actions in cervical pregnancy.

For the fruit set and economic productivity in almonds should be used as the pollenizer in the orchard with the main varieties of flowering overlap due to the limited almond ovule longevity, the minimum time taken fertilization and fruit formation. Therefore, evaluation of effective pollination period and pollen tube growth rate and inoculated with eggs is great importance for fruit set and successful fertilization. In this regard, the influence of pollen tube in different parts pistil three cultivars and five genotypes the times 24, 48, 72, 96 and 120 hours after pollination was evaluated by fluorescente microscope. Genotype A9.7 as female parent with Tuono cultivar and genotypes A230,A10.11, A8.39 as male parents, cultivar Shokofeh as female parent with Tuono and Sahand cultivar and A230, A1.16 genotypes as male parent and Tuono cultivar as the female parents, with Sahand cultivar and A230, A1.16, A9.7 genotypes as male parents were crossed. Results showed that at the 24 hours after pollination, pollen tube to the upper 1/3 pistil and at the 48 hours In most crosses pollen tube penetrate to the ovary middle. At the 72 hours after pollination of crosses ♀A9.7 × ♂A230, ♀Tuono × ♂A9.7 and Tuono open pollination the pollen tube could the ovary that showed high pollination period and the chance successful fertilization were crosses. 96 hours after pollination in the all the crosses pollen tub receipt to the ovary and at the 120 hours of pollen tubes penetrated percentage the ovary were increased.

Apple is the most important horticultural crops; each year is allocated to the high proportion of commerce of agricultural products. But don’t have a good quality of apples produced in Iran. This study aimed to evaluate the effects of klebron and calcium chloride on some vegetative traits and mineral elements of Red , Golden delicious and Fuji apple that grafted on MM106 in factorial randomized completely block design with 3 replications. Leaf chlorophyll content, leaf area surface, tree height, shoot, trunk length, diameter and nutrient content were determined.The results indicate that the highest effects of treatments on shoots length, diameter, trunk diameter, trunk height, N, K, Zn, leaf chlorophyll content, leaf area surface on Fuji apple and the lowest ones on Golden delicious apple.

Backgrounds Muscle cramp is a local, tangible, and involuntary spasm that usually involves the calf skeletal muscle; it is also one of the most common symptoms, particularly in the 3rd trimester of pregnancy. The current study aimed at determining the prevalence of leg cramps in the 3rd trimester of pregnancy and its relationship with nutritional behavior and consumption of supplements.
Methods & Materials The current cross sectional study was conducted on 439 pregnant females referred to Tabriz health care centers, Iran, from 2013 to 2014; the subjects were randomly selected from all pregnant females referred to the health care centers. Data were collected by a 4-part questionnaire including sociodemographic, obstetric characteristics, nutritional behavior of sub-health promotion lifestyle questionnaire (HPLP-2), and information about the features of leg cramps. Data were analyzed by descriptive and analytical statistics including independent t, Pearson correlation, and Chi-square tests.
Results According to the results of the current study, 57.9% of the participants developed leg cramps in the 3rd trimester of pregnancy. The mean ± standard deviation (SD) of the cramp numbers per week was 6.0±178.17, length of leg cramps 40.2±178.1 minutes, and severity of leg cramps 6.0±2.6. There was no significant correlation between the characteristics of leg cramps in pregnancy including number, length, severity, mean score of nutritional behavior, and consumption of supplements.
Conclusion Leg cramp is a common side effect in the 3rd trimester of pregnancy. It is the best to perform clinical trials to prevent and treat leg cramps during pregnancy.

The market sales of ready to use fresh cut fruits have grown rapidly in recent decades. Kiwi fruit is an important fruit that its marketing as fresh cut has increased in recent years. The main limiting factors in shelf life of fresh cut fruits are microbial spoilage, drastic softening and browning. In this study, the effects of oxalic and citric acids, both at 0, 2, 4 and 6 mM concentrations, with or without ultra-sonic treatment were investigated on the increasing the shelf life of fresh cut kiwi fruit. After treatments, the fresh slices were stored at 2°C for 7 or 14 days and assessed for several traits and analyzed. Results showed that, oxalic and citric acid treated slices, in comparison to the control, had greater marketability, as well as higher flesh firmness, titrable acidity, ascorbic acid content, total phenol content and antioxidant capacity and smaller bacterial forming colony unit (CFU). Among the treatments, 2, 4 and 6 mM oxalic acid and 6 mM citric acid treatments were found more appropriate than the reaming treatments. Application of ultra-sonic treatment, despite the reduction of microbial load and maintaining antioxidant capacity, had no effects on marketability of fresh cut kiwi fruit. Hence, application of organic acid treatments as dipping can be used to increase the shelf life of fresh cut kiwi fruit.

Background and Mothers are highly vulnerable during pregnancy and after childbirth. Some problems could even lead to mortality and morbidity after childbirth. Therefore, this study was carried out to evaluate the effect of lifestyle educational package on prevention of postpartum’s health problems in nulliparous mothers. This randomized clinical trial was conducted on 220 nulliparous women in postpartum ward. The subjects were allocated into two groups using block randomization method. Intervention group received face to face training, telephone counseling, booklets and informative text messages (both fathers and mothers), while the control group had no education or training. Any health problem on the day of discharge and two and six weeks after delivery were compared between the two groups using logistic regression test. By lowering the frequency of health problems during pregnancy, the chances of developing some complications including constipation, hemorrhoids, anal fissure, abdominal pain, headache, painful or infected suture, sleep problems during the second and sixth weeks postpartum as well as the chances of having cold and fever, backache, leg cramp, breast pain, nipple fissure, fatigue or weakness, sadness and discomfort and vaginal infection during the sixth weeks of postpartum decreased by more than 50% in educational group compared with the control group. In this study, postpartum lifestyle intervention reduced the chance of developing many health problems. Therefore, more comprehensive interventions should be carried out by healthcare providers during pureperium period in postpartum ward and the health centers for mothers and fathers.

Evidence indicates that sleep may be affected by using vitamins and minerals or lack of them. This study aimed to determine the effects of vitamin D and calcium-vitamin D in the treatment of sleep disorders in pregnant women with leg cramps. This triple-blind randomized controlled clinical trial took place on 126 pregnant women referred to Tabriz health centers، Tabriz، Iran، in 2013-2014. Subjects were allocated in to three groups، using block randomization. The groups received vitamin D، calcium-vitamin D and placebo pills daily for 60 days. Sleep score was measured before and after the intervention، using the Pittsburgh Sleep Quality Index. ANCOVA test was used for data analysis. Controlling baseline score before the intervention، there was no significant differences in the sleep quality score after intervention between the group receiving calcium-vitamin D and the control group (adjusted difference: -0. 3، 95% confidence interval: -1. 4 to 2. 1)، the group receiving vitamin D and controls (adjusted difference: -0. 007، 95% confidence interval: -1. 7 to 1. 7) and between the two groups receiving calcium-vitamin D and vitamin D (adjusted difference: -0. 3، 95% confidence interval: -1. 4 to 2. 1). Also، there was no significant difference between the groups in sleep quality subscales (P > 0. 05). The results show that calcium-vitamin D and vitamin D does not effect on improving the sleep quality in pregnant women with leg cramps.

Lack of awareness and the False beliefs about postpartum care may lead to maternal and child health problems. Thus, changing them through effective training methods should be considered as a priority. This survey was conducted to evaluate the effect of educational package on nulliparous mother’s Knowledge and belief about postpartum lifestyle. This randomized clinical trial was carried out on 220 nulliparous women in the postpartum ward in Tabriz, in 2013. The subjects were allocated into two groups using block randomization method. Intervention group received face to face education, telephone counseling, booklets and educational SMS and control group received postpartum Ward’s routine educations. Questionnaires of Knowledge and belief about postpartum lifestyle were completed by mothers at the first (or second) day after delivery and then 42 days later. Data was analyzed by SPSS-18, Independent t-test, Fisher's exact test, chi-square, chi-square for trends and ANCOVA. P<0.05 was considered significant. There were no significant statistic differences in terms of demographic characteristics and also pre-intervention lifestyle knowledge and belief scores between two groups (P>0.05). With adjusting pre-intervention knowledge and belief score, the mean scores of knowledge [adjusted mean difference 17.2, (CI: 95%: 20.2 to 14.3)] (p<0.001) and beliefs [28.7 (32.2 to 25.2)] (p<0.001) among the intervention group was significantly higher than those in control group. This study demonstrated the positive effectiveness of simultaneous use of simple and practical training techniques without financial burdens to promote nulliparous mother’s knowledge and belief about postpartum lifestyle. Yet, we cannot draw conclusions about which method is most effective, therefore more research is needed in this field.

Postpartum period can influence on the women''s hygiene and lifestyle. Postpartum lifestyle includes physical activity، nutrition and health-related behaviors. Women''s knowledge about puerperium care and health concerns enables them to prevent the complications. This study was performed with aim to assess knowledge and belief regarding postpartum lifestyle and its predictors among nulliparous mothers in Tabriz. This cross-sectional study was conducted on 220 nulliparous mothers admitted in postpartum wards in two medical and training hospitals and one private hospital in Tabriz in 2013. Convenience method was used for sampling. Data was collected using questionnaires of socio- demographic، knowledge and belief related to lifestyle. The data analysis was performed by SPSS software (version 18) and independent t-test، one way ANOVA، univariate and multivariate general linear model. The Mean±SD score of knowledge and belief were 72. 6±16. 9 and 50. 4±12. 5، respectively، of the attainable range score of 0-100. According to general linear model and with adjusting on other variables، having university education and receiving care from both physician and health center had statistically significant positive association with knowledge score، and there was significant positive relationship between education level and belief (P=0. 015). In the present study، the rate of knowledge of lifestyle was good and belief score was at moderate level. Education level and place of receiving prenatal care were the most important variables affecting knowledge and belief about postpartum lifestyle.

Regarding the rapid increase in the number of doctoral students in nursing, evaluation of PhD course to ensure quality of education is necessary. By the assessment of doctoral program from the viewpoint of the students, this study aims to provide a clear picture of the educational quality of this course. In this descriptive study, 64 doctoral students recruited by census from the nursing and midwifery schools of Tabriz, Shiraz, Mashhad and Tehran University of medical sciences were surveyed. Quality of PhD nursing course was evaluated by international questionnaire of QCSI (quality criteria, standards and indicators) in three dimensions of educational programs, faculty and resources. Data was analyzed by descriptive statistics using SPSS-PC (v. 13.5). The mean score of doctoral students’ point of view in the three parts of educational programs (48.4±3.17), faculty (31.42±2.03) and resources (18.95±2.76) was moderate. In the dimension of educational programs, components of emphasizing the research (49.3 ±0.67) and teachers’ support of students (3.32 ± 0.64) were more satisfied by students. The students were dissatisfied with the adequacy of faculty members (1.37 ± 0.77) and relevance of doctoral courses with nursing profession (1.84 ± 0.66). In the faculty dimension, students had been criticized the teachers’ performance for the supervision of dissertations (1.15 ± 0.60), and teachers’ knowledge (1.67 ± 0.87). In the resource dimension, students were dissatisfied of the adequacy of financial resources (1.95 ± 0.75) and necessary infrastructure for research (1.98 ± 0.66). Regarding the intermediate quality of doctoral course of nursing in the dimensions of curriculum, faculty and resources, revising the content of courses, increasing the number of faculty members and improvement of the resources are necessary to improve the quality of the course.