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Background: The Iranian National Health Service (NHS) suggested that gynecologists face a higher risk of medicolegal claims, with a significant number of claims being related to delivery events. This study aimed to investigate the factors associated with delivery related claims. Method: In this cross-sectional study, we conducted an analysis of medico-legal documents which related to complications during delivery events and presented to Iranian Medical Legal Organization spanning from March 2018 to February 2020. A total of 227 legal prosecutions that were initiated by patients or, in cases where that wasn't possible, by their families, were included in the study and all of them were evaluated in commission with experienced professionals. The data collection phase occurred between February 2023 and May 2023. The collected data encompassed various aspects, including patient characteristics mode of delivery, reasons for claims, hospital type, accused party, the occurrence of instrumental delivery and the final disposition of the claims (paid claims or closed claims). Paid claims represent successful lawsuits where the healthcare provider or their insurer made a financial settlement to the patient. Closed claims encompass those that were either denied or dismissed. Chi-square or t-tests were employed to compare factors between paid claims and closed claims. Result: In this study, it was observed that vaginal delivery was performed in 51.1% of the claims, whereas 48.9% underwent a caesarean section.. Approximately half of the claims were against obstetrician-gynecologists, and 33% of the claims against other providers were against midwives.. The majority of complaints were related to perinatal mortality (34.8%) and neonatal asphyxia (18.5%). In 58.1% of cases, no malpractice was identified, while 41.9% resulted in paid claims. Also, there were no significant differences between the paid claims and closed claims groups in several factors, such as the type of hospital (P = 0.904), maternal age (P = 0.157), type of delivery (P = 0.080), and accused party (P = 0.168). However, the number of instrumental deliveries (13.8% of vaginal deliveries) and the reasons for claims, exhibited significant differences between the two claims (P = 0.021, P<0.001 respectively). Conclusion: This study found that maternal complications were more common in caesarean sections, while neonatal claims were more prevalent in vaginal deliveries. The study recommended public health interventions to reduce the overall prevalence of delivery-related claims. [ABSTRACT FROM AUTHOR]

Background: This meta-analysis aims to evaluate the potential link between common variations in the Surfactant Protein-B (SFTPB) gene and the risk of bronchopulmonary dysplasia (BPD) in preterm neonates. Methods: All pertinent articles published prior to February 1, 2024, in PubMed, Web of Science, EMBASE, CNKI, and Scopus databases were reviewed. Results: Nineteen case-control studies involving 1149 BPD cases and 1845 non-BPD controls, were analyzed. Combined data indicated a significant link between SFTPB −18 A > C and Intron 4 VNTR polymorphisms with increased BPD susceptibility, while the 1580 C > T polymorphism provides a protective impact on BPD initiation. Conclusions: Pooled data indicated a significant association between SFTPB −18 A > C and Intron 4 VNTR polymorphisms with increased BPD risk, whereas the 1580 C > T polymorphism confers protection. These findings suggest a genetic susceptibility to BPD, underscoring the complex interplay of different genetic elements in its development. [ABSTRACT FROM AUTHOR]

Rapid urbanization worldwide has significantly altered urban climates, creating a need to balance urban growth with thermal environmental quality for sustainable development. This study examines the relationship between land surface temperature (LST) and urban characteristics, particularly focusing on how green cover can mitigate urban heat and how air pollution can increase temperatures. Recognizing the predictive value of LST for urban heat island (UHI) intensity, we analyzed three distinct U.S. cities—Chicago, San Francisco, and Phoenix—each characterized by unique climate and urban planning features. This study investigates the relationship between atmospheric pollutants (SO2, NO2, CO, O3) and the Normalized Difference Vegetation Index (NDVI) with land surface temperature (LST) using regression and correlation analyses. The analysis aims to elucidate how changes in atmospheric pollutants and NDVI affect variations in land surface temperature. Regression analysis is employed to estimate the coefficients of independent variables and quantify their impact on LST. Correlation analysis assesses the linear relationships between variables, providing insights into their pairwise associations. The study also examines multicollinearity between independent variables to identify potential confounding factors. The results reveal significant associations between atmospheric pollutants, NDVI, and land surface temperature, contributing to our understanding of the environmental factors influencing LST dynamics and informing climate change mitigation strategies. The observed inconsistencies in correlations across cities highlight the importance of the local context in environmental studies. Understanding these variations can aid in developing tailored urban planning policies that consider unique city characteristics for more effective climate resilience. Furthermore, a positive association was consistently obtained between pollutants and LST, indicating that increased pollution levels contribute to higher surface temperatures across different urban settings. [ABSTRACT FROM AUTHOR]

The coronavirus disease 2019 (COVID-19) is currently representing a global health threat especially for fragile peoples, such as cancer patients. A few studies have described that people with a breast cancer more likely to be infected with COVID-19. Here, we performed a meta-analysis to assess the proportion of breast cancer patients with SARS-CoV-2 infection during the COVID-19 pandemic. A comprehensive literature search of the PubMed, Web of Sciences, Scopus, MedRxiv, SID, and CNKI database was performed. A total of 26 studies with a total of 6,537 infected cancer patients and 1,093 breast cancer patients with COVID-19 met our inclusion criteria. Pooled data showed that the proportion of breast cancer patients with SARS-CoV-2 infection was 17.1% (95% CI 0.144-0.201) in total infected cancer patients. Stratified analysis showed that the proportion in Caucasian and Asian infected breast cancer patients was 17.6% and 14.5%, respectively. Moreover, the proportion was the highest in France (19.3%) followed by US (19.2%), China (14.8%) and UK (13.8%). Our combined data indicated that the proportion of breast cancer patients with SARS-CoV-2 infection during the COVID-19 pandemic was 17.1%. However, we need to more high-quality and multicenter studies from different ethnicities to draw more accurate findings. [ABSTRACT FROM AUTHOR]

HELLP syndrome is a disorder during pregnancy which is defined by elevation of liver enzymes, haemolysis, and low platelet count. This syndrome is a multifactorial one and both genetic and environmental components can have a crucial role in this syndrome's pathogenesis. Long noncoding RNAs (lncRNAs), are defined as long non-protein coding molecules (more than 200 nucleotides), which are functional units in most cellular processes such as cell cycle, differentiation, metabolism and some diseases progression. As these markers discovered, there has been some evidence that they have an important role in the function of some organs, such as placenta; therefore, alteration and dysregulation of these RNAs can develop or alleviate HELLP disorder. Although the role of lncRNAs has been shown in HELLP syndrome, the process is still unclear. In this review, our purpose is to evaluate the association between molecular mechanisms of lncRNAs and HELLP syndrome pathogenicity to elicit some novel approaches for HELLP diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Key Clinical Message: This paper highlights that diagnosis and treatment of one ectopic pregnancy does not rule out the happening of a second ectopic pregnancy in the same patient concurrently, especially if the patient has rising β‐hCG and persistent symptoms. Bilateral tubal pregnancy (BTP) is the most uncommon form of tubal ectopic pregnancy. Complications can lead to maternal morbidity and mortality. We reported a case of left tubal pregnancy and the patient underwent laparoscopic salpingostomy. During the follow‐up, the contralateral ectopic pregnancy was discovered and treated with MTX. [ABSTRACT FROM AUTHOR]

The coronavirus disease 2019 (COVID-19) pandemic is the main challenges to public health systems worldwide now. Cancer patients are considered as a high risk group during the COVID-19 pandemic. Considering the evidence so far, cancer as underlying comorbidities might increase the risk of death in patients with COVID-19. Many cancer patients with increased risk of contracting COVID-19 than the general population regularly visit health facilities for treatment and disease surveillance. Thus, the COVID-19 pandemic has a profound impact on cancer care and treatment. Here, we attempted to summarize the current suggestions for handling of cancer patients during COVID-19 pandemic. We carried out a integrative literature review using several online bibliographies. A total of 113 papers were accessed for the time frame between October 05 2020 and October 10 2020. After screening of titles and full-texts, 10 publications were selected in this study. In this work some recommendations and guidelines that would help for management and treatment of cancer for the purpose of address the challenges during COVID-19 pandemic were collected. We hope that this collection recommendations and guidelines assist health care providers in management of individuals with underlying malignancy during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: Abnormal uterine bleeding (AUB) that is any irregularity in menstrual cycles causes women to refer to clinics. This study aimed to compare the efficacy, safety, and complications of endometrial ablation by the thermal balloon (Cavaterm) method with the hysteroscopy loop resection method in the treatment of AUB. Materials and Methods: The present study is an open-label, randomized clinical trial that was performed in the two hospitals, Shahid Akbarabadi and Hazrat Rasoul Akram, of Tehran, Iran, from December 2019 to October 2020. Patients were randomly allocated to the two groups of interventions by a simple randomization method. The proportion of amenorrhea (as primary outcome) and consequent hysterectomy and patient satisfaction (as secondary outcomes) was assessed using the Chi-square test and independent t test. Results: There was no significant difference between the two groups in the baseline characteristics. The percentage of intervention failure was statistically higher in the hysteroscopy group (24%) in comparison with the Cavaterm group [8.2%, P=0.03, relative risk (RR)=1.63, 95% confidence interval (CI): 1.13-2.36]. Mean ± standard deviation of satisfaction based on the Likert score in the Cavaterm group and hysteroscopy group were 4.3 ± 1.21 and 3.7 ± 1.56, respectively, that showed a significant difference (P=0.04). Assessing the procedural complications, the rate of spotting, bloody discharge, and malodor discharge was significantly higher in the Cavaterm group. In contrast, postoperative dysmenorrhea is more common in the hysteroscopy group. Conclusion: Cavaterm ablation is accompanied by a higher success rate of amenorrhea and patients' satisfaction than hysteroscopy ablation (registration number: IRCT20220210053986N1). [ABSTRACT FROM AUTHOR]

Background: We studied the number of lymph nodes (LN) assessed in gastric cancer, and evaluated the association between different factors and a lower number of LN assessed. Methods: We conducted a retrospective study in three hospitals in Tehran city, I.R. Of Iran. We used patient medical and pathological reports to obtaine personal and clinical information. We studied the association of being on the N3 stage with the number of assessed lymph nodes (NALN), gender, tumor size, T stage, hospital, tumor site, histopathological diagnosis, tumor grade and age at diagnosis. In addition, we estimated the association between NALN and different clinical variables. A logistic regression model estimated the crude and adjusted odds ratios (OR) and corresponding 95% confidence intervals (95% CI). Results: The average number of NALN was 10.48 (±6.9). We found that the probability of being diagnosed as stage N3 was significantly lower in patients who had less than 15 LN assessed in their pathology reports compared to those who had more than 15 LN assessed (OR=0.2; 95% CI 0.1-0.4). The hospital and tumor size were significantly associated with NALN. Conclusion: Lower NALN led to stage migration and underestimation of the real tumor stage in GC patients. The LN assessments were lower than those recommended by the American Joint Cancer Clinician Association in all the three hospitals included in this study. Developing national guidelines, training surgeons and pathologists, conducting regular monitoring and evaluating the data are necessary to increase NALN and thus improve the staging of GC patients. [ABSTRACT FROM AUTHOR]