Shiraz Emedical Journal
Volume:19 Issue: 3, Mar 2018

Developing of supporting programs for mothers during labor and childbirth based upon their needs could play an important role in reduction of elective cesarean section. The present study aimed to validate a logic model program for supporting mothers during labor and childbirth using a Delphi technique.
This study was a three round Delphi engaging a panel of 25 experts of different specialties to rate and discuss the component of a labor support program. The program components were taken from the qualitative findings of a grounded theory study. The process of selecting expert panel members was carried out using the snowball sampling. In the first round of Delphi the experts were asked to offer their suggestions on a draft of the supporting program. After analyzing the first round data and adding the new suggestions, members were asked in round two to grade the value of statements based on the Likert scale to state their agreement. The third round was related to the discussion on disagreements and reaching consensus.
The panelist s approved 46 statements out of original set of over 51 statements via three round of Delphi. The agreement percentage of 80.9% were achieved for consensus. The results illustrated six major themes in the logic model program including preparation (10 statements), equipment and facilities (three statements), education (eight statements), process and activities (10 statements), interventions (13 statements) and evaluation (two statements).
The current paper provided clear principles and standards regarding how to practically do a comprehensive supportive care during labor and delivery.

Knowing the quality of sleep in the elderly and its effective factors helps to take measures in increasing or decreasing their effect.
The aim of this study is to determine the sleep problems and its effective factors in the elderly of Amirkola, the northern part of Iran.
This cross-sectional study was extracted from the Amirkola health and ageing project (AHAP), which is a cohort project regarding the elderly in the city of Amirkola, the northern part of Iran. Since 2011, it has been started and has continued so far. Data including age, sex, level of education, life status, occupation, smoking, physical activity, self-reported chronic diseases, depressive symptoms by Geriatric depression scale (GDS), cognitive status by mini-mental state examination (MMSE), history of medication, and questions regarding sleep problems were collected by interviewing with older people or their close relatives.
The overall prevalence of sleep disorders in this study was 354 (24.8%). Gender, drug use, marital status, chronic pain, depression, urinary incontinence, education level, metabolic syndrome, occupation, MMSE, hypnotics, and diabetes were associated with the prevalence of sleep disorders. According to the logistic regression analyses, 12-month back pain (OR = 1.64, P = 0.003), hypnotic drugs (OR = 1.5, P = 0.03), depression (OR = 1.66, P = 0.001), age range of 75 to 79 years old (OR = 0.58, P = 0.01), accompanying chronic disease (OR = 1.15, P This study showed a high prevalence of sleep disorders in the elderly in Amirkola, especially in women. It is necessary to assess all older individuals with sleep disorders for identifying and treatment risk factors.

Oligodendrocytes are myelin-producing cells, which develop from oligodendrocyte precursor cells (OPCs) and may be damaged in multiple sclerosis (MS) and traumatic brain injuries. Promotion of neural stem cell (NSC) differentiation into oligodendrocytes in vivo is a viable strategy to replace the lost myelinating cells and restore motor functions in such debilitating diseases. Crocus sativus L. or saffron has been used as a spice since ancient times. Saffron and its major active component, crocin, are well-known for their medicinal and neuroprotective activities. The current study aimed at assessing the effect of saffron extract and crocin on the differentiation of NSCs into OPCs.
To isolate NSCs, 14-day embryonic rats cortices were cultured, using the neurosphere assay. NSCs were cultured in a complete NSC medium under 4 different treatment conditions: 1, Negative control group, 10 ng/mL of basic fibroblast growth factor (bFGF); 2, Positive control group, 10 ng/mL of bFGF plus 30 ng/mL of platelet-derived growth factor-AA (PDGF-AA); 3, Crocin group, crocin extract plus 10 ng/mL of bFGF; and 4, Saffron group, saffron extract plus 10 ng/mL of bFGF in 2 or 5 days. The level of Olig2 protein, an early OPC marker, was evaluated by flow cytometry 2 days after the treatment. The level of sox10 mRNA expression, involving in OPC maturation processes, was assessed in the study groups via quantitative real-time polymerase chain reaction (PCR), 5 days after the treatment. All the experiments were done in triplicate. The data were analyzed using one-way ANOVA with Graph Pad Prism version 6.01; P The present data demonstrated that, similar to the positive control group, the rate of olig2 cells in the crocin and saffron extract groups did not exceed 80% indicating that these components could significantly increase olig2 expression in NSC differentiation compared with that of the negative controls (P It can be concluded that crocin and saffron are the proper alternatives for PDGF-AA in the enhancement of NSC differentiation into oligodendrocytes.

When women’s’ lives enter a new phase after childbirth, they need to adapt to it in order to accept their motherhood role. Maternal competency depends on the mother’s perception of her maternal role and the ability to attain and fulfill it. The aim of this study was to examine the association between maternal sense of competence and self-efficacy in the postpartum period.
In this cross-sectional study, 305 Iranian women were selected randomly via a two-stage cluster sampling method at the end of the 4th postpartum month. Data were collected from August 2016 to January 2017 and by using the socio-demographic characteristics questionnaire, parenting sense of competence scale, and maternal self-efficacy questionnaire. The statistical tests including Pearson correlation, Independent sample t-test, One-way ANOVA, and General linear model were used for data analysis.
The mean (SD) score of self-efficacy was 33.8 (5.1) and mean (SD) score of maternal sense of competence was 79.2 (13.8). Between maternal competency and self-efficacy a significantly positive correlation (P = 0.000, r = 0.364) was found. According to the adjusted general linear model, mother’s age, income, spouse’s occupation, type of pregnancy, and self-efficacy have statistically significant relationships with the maternal sense of competence and explains 34.9% of the variation in the maternal sense of competence score.
The findings of the present study showed that increased postpartum self-efficacy is associated with improved maternal competency, which requires health providers to evaluate postpartum maternal self-efficacy and make the necessary interventions if it is low.

Epidermal cysts are mostly benign tumors with a dome-like appearance usually observed in the body, behind the ears, and in the cervical area.
The study aimed to compare the surgical results of minimal excision and elliptical excision techniques in the surgical management of epidermal cysts.
In a 24-month period, from 2012 to 2015, 356 patients with benign, non-infected epidermal cysts were surgically managed with minimal excision (n = 178) or elliptical excision (n = 178) techniques. Patient information, volume and place of the lesion, the length of the wound, the time of surgical procedure, and recurrence rate were evaluated using SPSS software at a significance level of The mean length of the wounds in the minimal excision and elliptical excision groups was 2.3 ± 0.32 and 2.7 ± 0.11 cm, respectively (P = 0.001). The mean operative time was significantly shorter in the minimal excision technique (6.4 ± 2.09 minutes) than in the elliptical excision technique (11.3 ± 3.35 minutes) (P = 0.001). There was no significant difference in the recurrence rate in minimal excision technique (2.8 %) than in elliptical excision technique (3.3%) (P = 0.065).
Minimal excision produced a superior cosmetic result. Epidermal inclusion cysts measuring less than 3 cm that were observed on the head or cosmetically important zones were optimally managed with the minimal excision technique.

Tuberculosis (TB) is the second leading cause of death from infectious diseases. Delayed diagnosis of TB and emergence of multidrug-resistant TB are among the most important issues related to physician performance.
This study aimed to assess the level of knowledge and practice of TB among medical students.
In this longitudinal, interventional study, 60 final-year medical students, who were referred to the Tuberculosis Research Center, affiliated to Shiraz University of Medical Sciences, were assessed regarding the knowledge and practice of national TB guidelines before education, 1 month after education, and 2 years after education. Data were collected using a valid and reliable questionnaire (Cronbach’s alpha, 0.62). The questionnaire consisted of 10 and 8 questions about knowledge and practice, respectively. The collected data were analyzed using SPSS.
Overall, 33 women and 27 men were recruited in this study. The mean age of the participants was 24 ± 1.5 years. The mean time from the internship period was 7.1 ± 4.4 months, and 53.3% of the participants had attended the infection ward during their clinical course. The median score of both knowledge and practice increased by about 50% after 1 month of education, while only practice showed a 25% increase after 2 years of education. No significant difference was found regarding knowledge and practice between genders. In addition, there was no significant difference among individuals who attended the infection ward and those who did not. Similarly, there was no significant difference among individuals who participated in continued medical programs after graduation and those who did not participate in such programs; also, students who visited patients with suspected TB were not significantly different from those who did not. However, a higher frequency of acceptable knowledge (≥ 50%) was reported in students who visited patients with suspected TB; also, a higher sum score of knowledge and practice was found in male students.
This study showed that the level of TB knowledge and practice was not optimal among medical students. Therefore, for achieving a higher level of knowledge and practice, a regular patient-centered educational approach is needed, especially for postgraduates.