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Naser Gharebaghi , Mohammadamin Valizade Hasanloei, Seied Hasan Adeli , Seied Arash Mansuri Zangir , Javad Rasuli ,
Volume 71, Issue 10 (January 2014)
Abstract

Background: Stress Ulcer Prophylaxis (SUP) is important in patients in Intensive Care Units (ICU). In this study, we evaluated the efficacy of the American Society of Health System Pharmacists (ASHP) guidelines, for stress ulcer prophylaxis. Methods: In this Quasi experimental study, data of patients that admitted to the ICU of Imam Khomeini Hospital of Urmia was recorded for three months. Then our guideline that was selected on the basis of ASHP guidelines were presented to physicians for one month and then patients’ data were collected again. The patients that hospitalized due to acute gastrointestinal bleeding and died in the early hours of admission were excluded. The data were analyzed. Results: This study involved 234 patients, of them 112 patients (91.1%) in the pre- intervention period and 99 patients (89.2%) in the post-intervention period had received acid-suppressive therapy (AST) (P=0.632). Of 77 patients (62.8%) in the pre- intervention period and 88 (79.3%) in the post-intervention period had an indication for SUP according to our ASHP-based guideline (P=0.005). Of the patients without an indication for SUP, 39 of 123 (31.7%) received AST in the pre-intervention period versus 18 of 111 (16.2%) in the post-intervention period (P=0.006). of 112 (91.1%) cases in the pre-intervention period compared with 93 (83.8%) cases of the prescription drug order was incorrect (P=0.092). Gastrointestinal bleeding were in five patients (4.1%) found during the pre-intervention period and 8 (7.2%) cases in the post-intervention period (P=0.295). Conclusion: In this study the majority of cases not been in accordance with the ASHP-based guideline and our education did not affect the quality of stress ulcer prophylaxis. It seems that more attention to the training of physician in the prophylaxis of stress ulcer can be effective in improving the health status of patients and additional costs may be reduced.
Fatemeh Habibollahi, Ghazaleh Eslamian, Kiana Hasibi , Sepehr Khoshbaf Khiabanian , Bentolhosna Dehghan Nayeri , Aref Adeli Mosabbeb ,
Volume 82, Issue 12 (March 2025)
Abstract

Background: Infertility is defined as the failure to achieve pregnancy after one year or more of regular unprotected sexual intercourse. Assisted reproductive technologies (ART) represent a key therapeutic approach for infertile couples. Bisphenol-A (BPA), a compound found in plastic polymer products, has been associated with increased infertility risk. This systematic review addresses whether BPA affects ART outcomes.
Methods: A comprehensive and systematic literature search was conducted across PubMed, Google Scholar, Web of Science, and Scopus up to December 2024 without any language or time restrictions. The search strategy combined relevant keywords and medical subject headings such as “bisphenol A,” “infertility,” “assisted reproductive technology,” “in vitro fertilization,” and “embryo implantation.” All human studies assessing the relationship between BPA exposure and ART outcomes were considered. After removing duplicates and screening titles and abstracts, 23 studies that met the inclusion criteria were reviewed in detail. The selected studies included cross-sectional and prospective cohort designs, and data on sample size, BPA measurement methods, and reproductive endpoints were extracted for qualitative synthesis.
Results: The reviewed studies consistently indicate that exposure to BPA is associated with adverse reproductive outcomes, particularly in women undergoing IVF treatment. Evidence suggests that higher BPA levels correlate with fewer retrieved oocytes, reduced oocyte maturation rates, and impaired ovarian response to hormonal stimulation. Several studies also observed reduced estradiol concentrations and lower fertilization and cleavage rates, leading to decreased implantation success and clinical pregnancy rates. In addition, diminished ovarian reserve markers, such as anti-Müllerian hormone and antral follicle count, have been negatively influenced by BPA exposure. Male factors were also affected, with reports of decreased sperm motility, abnormal morphology, and increased DNA fragmentation, which could compromise embryo quality and early development. Variability in study methodologies, small sample sizes, and differences in BPA detection techniques, however, make direct comparison challenging.
Conclusion: Current evidence supports an inverse association between BPA exposure and fertility outcomes, but further prospective studies with larger sample sizes and more precise measurement methods are needed.


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