مجله دانشکده پزشکی اصفهان
پیاپی 522 (هفته دوم خرداد 1398)

Pregnancy affects women’s sexual function. Although previous studies have introduced various factors affecting sexual function, but few studies have examined the prognostic factors on sexual dysfunction during pregnancy. These factors are influenced by cultural issues of each society. This study aimed to determine the prognostic factors of sexual dysfunction in selected pregnant women in Tehran City, Iran. This descriptive analytical study was conducted on 250 pregnant women in Tehran selected using convenience sampling method. The data collection instrument consisted of a questionnaire for individual and midwifery information, female sexual function index, Enrich marital satisfaction questionnaire (short version), female sexual distress scale, and prenatal distress questionnaire. The data were analyzed via SPSS software using Kolmogorov-Smirnov, one-way ANOVA, Pearson correlation, and linear regression (Enter method) statistical tests. The significance level was considered to be less than 0.05. The mean (standard deviation) of sexual function score was 22.27 (9.73), and the majority of pregnant women (72%) had sexual dysfunction. Among the areas of sexual function, women had the highest rates of sexual dysfunction in the area of “pain”. The duration of marriage, prenatal distress, and sexual distress were significantly predictive factors of sexual dysfunction in pregnant women (P < 0.05). The duration of marriage, prenatal distress, and sexual distress significantly predicted sexual dysfunction in pregnant women. Knowing these factors is an important achievement for better prenatal care and designing interventional studies to improve sexual health during pregnancy.

Oxidative stress, defined as a disturbance in the balance between the production of reactive oxygen species (free radicals) and antioxidant defenses, is discussed in relation to its possible role in the production of tissue damage in diabetes mellitus. Regarding the prevalence of gestational diabetes mellitus in recent decades and the results of some studies about the effect of nutritional anomalies and oxidative stress, as well as insufficiency of studies on its occurrence, this study aimed to compare of oxidative stress indices in women with and without gestational diabetes mellitus. In a case-control study conducted in Isfahan Health Center No. 2, Isfahan, Iran, in 2017-2018, 37 women with gestational diabetes mellitus and 53 women without it mellitus were selected using convenient sampling method. Oxidative stress indices including glutathione (GSH), total antioxidant capacity, superoxide dismutase, non-esterified fatty acids (NEFA), catalase, and malondialdehyde were measured and compared between the two groups. The mean total antioxidant capacity was 441.6 ± 63 and 562.5 ± 44.9 μmol/l in women with and without gestational diabetes mellitus, respectively (P = 0.011). The mean catalase level in the two groups was 0.32 ± 1.12 and 1.79 ± 0.59 U/l, respectively, and the difference between the two groups was statistically significant (P = 0.024), but the other factors were not significantly different between the women with and without gestational diabetes mellitus. The levels of some oxidative stress markers such as total antioxidant capacity and catalase were significantly higher in women with gestational diabetes mellitus. Therefore, oxidative stress seems to play a role in the pathogenesis of gestational diabetes.

It seem necessary to assess the precision of scoring systems for estimating disease severity and prognosis of the patients in intensive care units (ICUs). In this study, we aimed to compare the predictive accuracy of a novel checklist (M score) with well-known scoring systems in non-trauma patients in ICU. Throughout a cross-sectional study in 2018, 835 non-trauma patients admitted in ICU with the age of more than 16 years were included. Mortality prediction was assessed using Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA), and M score at the first and last day of their ICU stay. Using logistic regression test, receiver operation curve, Pearson’s regression, chi-square, and independent samples t tests, the data from these three scoring systems were analyzed, and the sensitivity and specificity of systems were calculated. The cut-off point for predicting mortality was 13.5 for APACHE II, 15.5 for M score, and 6.5 for SOFA. The probability of death increased by increasing in any of studied scores. M score, which has been prepared for accurate easement of clinical and paraclinical status of patients by nurses and physicians, seems to be a good corrival for well-known scoring systems.

Intensive care unit (ICU) is among the most important hospital wards. Variety of scoring systems for evaluation of patients' status and prediction of hospitalization outcomes in ICU has been raised that each has strong and weak points; assessment of these characteristics tends to promote new scoring systems. The current study compared scoring systems of Mortality Probability Model-III (MPM-III) and Simplified Acute Physiology Score-III (SAPS-III) in trauma patients in ICU. This randomized cross-sectional study was conducted on 200 patients admitted in ICU because of trauma in years 2016-17. Patients' information including demographics, mean of systolic, diastolic, and arterial blood pressure, pulse, respiratory rate, temperature, Glasgow coma scale (GCS), arterial gas analysis, white blood cell (WBC) counts, hematocrit, bilirubin, creatinine, type of admission, and presence of underlying diseases were extracted from records; MPM-III and SAPS-III were measured for these patients and compared. MPM-III scoring system had discrimination of 0.935 [95% confidence interval (95%CI): 0.89-0.97; P < 0.001) in cut-off point of 0.13, and its sensitivity and specificity was 87% and 84%, respectively. For SAPS-III system, in cut-off point of 0.13, the discrimination was 0.77 (95%CI: 0.69-0.85; P < 0.001), with the sensitivity of 80% and specificity of 68%. Based on both MPM-III and SAPS-III systems, mortality was in correlation with duration of ICU admission (P = 0.001 for both systems) and duration of intubation (P < 0.001 for both systems), while only for SAPS-III, total duration of hospitalization was in correlation with mortality (P < 0.001). MPM-III scoring system was superior to SAPS-III regarding discrimination power in trauma patients. In addition, based on both systems, mortality rate was in direct association with days of ICU admission and intubation duration.

Self-renewal, multipotent, and immunomodulatory are properties of mesenchymal stem cells (MSCs) that make them a good candidate for cell therapy. Recently, MSCs and their secretions are considered in control of infectious disease. MSCs can recognize pathogens, migrate to infection site, and fight against them by redirecting immune responses and anti-microbial peptide secretion. In this review, the therapeutic role of MSCs in infectious disease is discussed. In this review article, we searched MSCs, interaction of MSCs and immune cells, MSCs in infection, and MSCs therapy in infectious disease as key words in valid databases including PubMed, Science Direct, Scopus, and Google scholar. Finally, 100 articles were selected and reviewed completely. According to the studies, MSCs therapy is a promising method for control of infectious disease. MSCs interact with both host immune systems and pathogen. The result of this interaction is inflammatory and anti-inflammatory responses, secretion of antimicrobial peptides, and influence on the differentiation and function of immune cells. Positive and negative effects of MSCs in the direction of immune response depend on the number of injections, infection phase, and stimulation of MSCs receptors. Therefore, comprehensive studies are needed to represent effective therapeutic protocols for any infectious disease.