Background: Preterm prelabor rupture of membranes (PPROM) accounts for one-third of preterm deliveries and is associated with neonatal and maternal mortality. Objectives: This study aimed to compare outcomes of expectant management in women with PPROM according to gestational age at delivery: 28 to 33+6 weeks versus 34 to 36+6 weeks. Methods: In this descriptive-analytical cohort study, 40 pregnant women with PPROM underwent expectant management and were categorized into two groups according to gestational age at delivery: 28 to 33+6 weeks and 34 to 33+6 weeks (n = 20 per group). Maternal and neonatal outcomes were compared using appropriate statistical tests. Results: The 28 to 33+6-week group had significantly higher rates of neonatal intensive care unit admission (85% vs. 15%, P < 0.001), respiratory distress syndrome (50% vs. 10%, P = 0.006), and neonatal hypoglycemia (85% vs. 5%, P < 0.001) than the 34 to 33+6-week group. Apgar scores at 1 and 5 minutes were also significantly lower in the earlier gestational-age group (P < 0.001). Conversely, neonatal sepsis was significantly more prevalent in the 34 to 33+6-week group (30% vs. 5%, P = 0.006). No significant differences were observed in maternal complications or mode of delivery. Conclusions: These findings suggest that expectant management of PPROM until 36 weeks may be feasible and may reduce complications of prematurity under strict monitoring. Larger multicenter trials are needed to confirm these associations.
Background: Type 2 diabetes is a prevalent chronic disease that requires sustained self-care and a positive attitude for its effective management. Despite the importance of these factors, interventions to improve them remain limited. Objectives: This study aimed to evaluate the effectiveness of an integrated educational program in improving self-care behaviors and attitudes toward diabetes among patients with type 2 diabetes. Methods: A pretest–posttest control group design was employed. Thirty patients with type 2 diabetes were selected via purposive sampling from healthcare centers in Sanandaj and assigned to experimental (n = 15) and control (n = 15) groups. The experimental group received a 10-session integrated educational program (60 minutes per session; two sessions per week), whereas the control group maintained their habitual daily activities throughout the study period and did not participate in any additional training. Data were collected using the Diabetes Self-Care Questionnaire and the third version of the Iranian Diabetes Attitude Scale (IR-DAS-3). Data were analyzed using analysis of covariance and paired-samples t-tests to assess between-group and within-group changes, respectively. Results: Comparison between the two groups showed significant differences in self-care and attitude toward diabetes scores (P < 0.05, based on the ANCOVA test). A significant increase in the self-care score was observed in the experimental group compared with the control group (P-value between groups = 0.001; partial η2 = 0.950). Likewise, after the study, the mean attitude toward diabetes score was significantly higher in the experimental group than in the control group, after controlling for the effect of the baseline score (P-value between groups = 0.001; partial η2 = 0.990). Conclusions: The integrated educational program effectively enhanced self-care behaviors and improved attitudes toward diabetes among patients with type 2 diabetes. These findings suggest that incorporating such experiential educational programs into standard diabetes care may be a valuable strategy for patient empowerment and improved health outcomes.
Background: Previous studies have demonstrated the role of inflammatory processes in the pathogenesis and progression of Alzheimer's disease (AD). Because currently available medications have insufficient clinical efficacy for the treatment of AD, lifestyle modifications, including exercise and dietary interventions, have become increasingly important for prevention and treatment. Objectives: This study aimed to determine the independent and combined effects of high-intensity interval training (HIIT) and omega-3 (OMG3) supplementation on amyloid beta precursor protein (App) mRNA expression, interleukin-1 beta (IL-1β) gene expression in brain tissue, and spatial memory in rats with AD. Methods: In this experimental study, 30 male Wistar rats aged 12 weeks and weighing 180 - 200 g were randomly assigned to five groups: Control, AD, AD + HIIT, AD + OMG3, and AD + HIIT + OMG3 (combined). To induce the AD model and memory impairment, scopolamine was administered intraperitoneally at 2 mg/kg/day for 9 days. The HIIT protocol consisted of 3 - 4 bouts of treadmill running at 30 m/min, 5 days per week for 8 weeks. The supplemented groups received Mega DHA, containing 10% eicosapentaenoic acid and 50% docosahexaenoic acid, via daily gavage for 8 weeks at a total product dose of 500 mg/kg/day. Forty-eight hours after the final interventions, the rats were sacrificed, and App mRNA and IL-1β gene expression in the brain were measured using real-time polymerase chain reaction. Spatial memory was assessed as the percentage of spontaneous alternation in the Y-maze test. Results: AD induction increased App mRNA and IL-1β gene expression in brain tissue. HIIT and OMG3 supplementation, alone or in combination, were associated with decreased IL-1β gene expression. App mRNA expression was reduced relative to that in the AD group only in the combined group. HIIT and OMG3 supplementation alone did not significantly alter App mRNA expression compared with that in the AD group. Conclusions: These findings suggest that combining HIIT with OMG3 supplementation improves cognitive function in the AD model by modulating neuroinflammation.
Background: Bisphenol A (BPA) may adversely affect the nervous system. Objectives: This study aimed to assess the effects of passive avoidance learning on BPA-induced toxicity, as indicated by serotonin 5-HT2α receptor density in the cerebellum, basolateral amygdala, and hippocampus of male rats. Methods: Thirty male rats (200 - 220 g) were allocated to six experimental groups. BPA was administered orally for 15 consecutive days. Learning and memory performance were assessed using a passive avoidance shuttle-box paradigm. Serotonin 5-HT2α receptor density was evaluated by immunohistochemistry in the selected brain regions. Immunohistochemical labeling was quantified by measuring color parameters using image-analysis software. Results: BPA at both doses reduced 5-HT2α serotonin receptor density in the examined brain structures. Passive avoidance learning mitigated the toxic effects of BPA on 5-HT2α receptor density in these structures. Conclusions: Overall, BPA exposure downregulated 5-HT2α receptors in the hippocampus, amygdala, and cerebellum of male rats, whereas passive avoidance learning and memory were associated with an increased receptor density.
