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Introduction: Combining research results with clinical practice has become a challenge. The critical appraisal helps make decisions. For this purpose, this study was performed aimed to critical evaluate the published clinical trials on "the effect of herbal medicine on striae gravidarum". Methods In this critical review, the clinical trials articles published between 1972 and 2017 about the effect of herbal medicine on striae gravidarum were searched in the electronic scientific databases including Web of Science, PubMed, Embase, Scopus, Google Scholar and Persian articles in SID, Magiran, Goggle Scholar, using the keywords (Striae gravidarum OR Striae OR Stretch Marks) AND (Prevention OR Treatment OR Control) AND (Cream OR Gel OR Oil) and (Striae or pregnancy striae or pregnancy lines) and (prevention or treatment or control) and (Cream or gel or oil). The lasted edition of the CONSORT checklist (2018) was used. The scoring range was 0-45. The articles based on the scores were classified into three categories: poor, moderate and good. Data were analyzed by SPSS software (version 22) and descriptive statistics. Results: Out of the 14 articles reviewed, the overall compliance of the quality of the reviewed articles was estimated 46% with the Consort 2018 criteria. In general, the biggest shortcoming was in the participation of stakeholders and then the method of work. The overall mean score of the articles was 20.86±7.18 from a minimum and a maximum of 9-33. Conclusion: The quality of the clinical trial reports on the effect of using herbal products on reducing pregnancy striae is not appropriate and desirable. Since the biggest shortcoming was in the method, it is recommended to solve these problems by using statistics and methodology experts and standard tools such as consort for self-evaluation of articles.

Background & Aim: Pregnancy is one of the enjoyable and evolutionary aspects of women’s life, which is often associated with many stresses and concerns. Counseling is one of the most appropriate interventions to reduce concerns and increase the decision-making power of pregnant women. This study aimed to determine the effect of solution-focused group counseling on pregnant women’s worries. Methods & Materials: A randomized clinical trial was conducted on 108 pregnant women with gestational age of 6 to 19 weeks and a score of worry ≥55, from May to September 2017 in health centers of Sabzevar University of Medical. The intervention group received a solution-focused counseling and the control group received routine prenatal care. Concerns of pregnant women were evaluated before, after, and two months after the intervention using the Farsi version of Cambridge Worry Scale. The data were analyzed using t-test, chi-square, and repeated measure analysis of variance through the SPSS software version 22. A P value less than 0.05 was considered statistically significant. Results: The mean score of worry before the study was 58.9±5.9 for the intervention group and 58.8±4.37 for the control group, and no significant difference was observed. After the intervention, these values for the intervention group and the control group were 34.6±13.3 and 57.7±8.78, respectively. Two months after the study, these values were 31.1±10.1 and 54.6±10.9, respectively. The analysis of variance with repeated measurements showed that pregnant women’s concerns about childbirth, fetal health, maternal health, and family relationships were significantly reduced after the intervention and two months later (P

Background: Phototherapy is the most effective treatment for neonatal jaundice and intermittent phototherapy is as effective as continuous phototherapy but with fewer complications and more benefits. This study compared the hospital length of stay, duration of phototherapy and the reducing rate of total serum bilirubin after 24 and 36 hours of phototherapy in two groups. Methods: The current double-blinded randomized controlled trial was conducted on 60 icteric term neonates from November 2016 to June 2017. A total of 60 icteric term neonates were randomly divided into two groups. In the continuous group, the phototherapy device was turned on for 24 hours and in the intermittent phototherapy group, the phototherapy device was turned on for 18 hours and off for eight hours. Inclusion criteria were term neonates with non-hemolytic hyperbilirubinemia admitted to the neonatal ward of Loghman Hospital, Tehran, Iran. Infants were excluded for any of the following reasons: Hemolytic anemia, prematurity, sepsis, sever hyperbilirubinemia (total bilirubin>18 mg/dl), direct hyperbilirubinemia and onset of jaundice within the first 24 hours of life. In both arms, phototherapy continued until total serum bilirubin reached

Introduction: Clinical trials in the field of menopause play a critical role in producing valid evidence due to the importance of women’s health in the family and society. The results of clinical trials could be used in the evidence-based medicine in case they have a good quality and precise methodology. Therefore, this study aimed to evaluate the quality of clinical trials published by Iranian authors regarding the effects of complementary medicine on menopausal symptoms. Materials and Methods: This descriptive study assessed the clinical trials published during 2007-2016 concerning the impact of complementary medicine on menopausal symptoms. The articles of Iranian journals indexed in SID, Iranmedex, Irandoc, Magiran, and Google Scholar were selected. Several keywords were utilized for searching, including menopause, complementary medicine, massage therapy, acupressure, herbal medicine, and clinical trials. Finally, 47 out of 238 retrieved articles were critically appraised using the Consolidated Standards of Reporting Trials (CONSORT) checklist 2010. The maximum and minimum score that each article could obtain was 37 and zero, respectively. All the data were analyzed using descriptive statistics by SPSS version 16. Results: The findings of present study demonstrated that the mean score of overall quality for the reviewed articles was 23.93±3.94 with the maximum and maximum scores of 16 and 33, respectively. It was revealed that among the 47 clinical trials, sample size calculation, randomization method, type and method of blinding, and the method for generating a random allocation sequence were mentioned in 21 (44.68%), 20 (46.5), 19 (40.42), and 35 (74.46%) studies, respectively. In addition, the used statistical methods were also noted in 46 (97.87%) studies. In the qualitative assessment, the highest mean score was obtained for the introduction and the least for the materials and methods parts. Conclusion: According to the results of this study, the clinical trials published in Iranian medical journals are moderate in terms of study design and reporting method. Consequently, it is recommended that the editors, referees, and researchers of clinical trials, apply a standard guideline for designing and reporting the results of clinical trials. Moreover, the necessary steps for trainings in this regard should be considered.

Introduction: Randomized controlled trials are critical and important studies in medical sciences. Due to the vital role of such studies in production of valid scientific evidence in the promotion of maternal health, this study was performed with aim to assess the quality of clinical trials in relation to the efficacy of massage therapy on labor pain intensity published by Iranian authors using CONSORT criteria. Methods: In this descriptive study, published Randomized Controlled Trials (RCTs) in relation to the efficacy of massage therapy on labor pain intensity were evaluated in Persian and English journals which are indexed in Google scholar, PubMed, Scopus, CINAHL as well as Persian databases such as SID, IranMedx, IRANDOC, and Magiran using the keywords of labor pain, massage, and randomized clinical trials from 1995 to 2017. Out of 155 articles, 20 RCTs were assessed using CONSORT, 2010 checklist. The minimum and maximum score of the checklist was zero and 37, respectively. Data were analyzed using descriptive statistical tests with SPSS software (version 14). Results: Based on the results of 20 selected articles about the effect of massage therapy on labor pain intensity, the overall accordance of the RCTs with CONSORT criteria was 54%. Totally, the highest defect was related to the section of methods and materials; in the items of this section, the highest defect was related to sample size, method used for randomized allocation and the method of blinding. The mean overall score of articles was 20.15±3.18 in the minimum and maximum range of 12-27. The highest percentage of reporting quality criteria was related to the methodology section, which was estimated to be 42%. Conclusion: The most common weakness of authors in reporting the results of RCTs was seen in the section of materials and methods which could be improved by more training of these issues, use of statistics and methodology specialists and also using of standard tools for self-evaluation of the articles.

Background: Postoperative pain is one of the most common complications following laparoscopic cholecystectomy. Because the majority of the analgesic drugs including opioids and nonsteroidal anti-inflammatory drugs have many side effects, using drugs with lesser side effects is beneficial. The aim of this study was to evaluate the effect of N-acetylcysteine on the pain after laparoscopic cholecystectomy. Methods: In a randomized clinical trial, in two university-affiliated teaching hospitals in Babol City (Shahid Beheshti and Shahid Yahyanezhad Hospitals), Iran, from August 2015 to March 2015, a total number of 38 patients with age of 20-50 years, who were candidates for laparoscopic cholecystectomy with American Society of Anesthesiologists Class-I were chosen and randomly assigned into two groups. The night before operation, 1200 mg oral N-acetylcysteine is given to intervention group. Also, they received 600 mg IV N-acetylcysteine in the morning before operation. In the control group, two vitamin C effervescent tablets as placebo were given at night before operation and 3 ml sterile water as placebo was injected in the morning of operation. Amount of pethidine consumption and the changes in hemodynamic in two groups was recorded and analyzed at 24 hours after operation. Results: The average of patients age was not significant different between two groups (P=0.23). Average of pain score in placebo group was 3.5 and in N-acetylcysteine group was 2.7 that it was not significant difference between two groups (P=0.06). Average of pethidine consumption in placebo group was 52 mg and in N-acetylcysteine group was 29 mg in 24 hours, that the difference was statistically significant between two groups (P=0.01) Conclusion: As the results of the study, it can be concluded that the anti-inflammatory effects N- acetylcysteine can inhibit the function of lipoproteins and prostaglandins, reduced glutathione peroxidase and dismutase has been restored and can be used to treat pain or analgesic dose reduction. In this study the N-acetylcysteine has reduced pain after laparoscopy and analgesic dose of mepridine.

Background & Aim: Pregnancy is one of the enjoyable and evolutionary aspects of women's life, which is often associated with many stresses and concerns. Counseling is one of the most appropriate interventions to reduce concerns and increase the decision-making power of pregnant women. This study aimed to determine the effect of solution-focused group counseling on pregnant women's worries. Methods & Materials: A randomized clinical trial was conducted on 108 pregnant women with gestational age of 6 to 19 weeks and a score of worry ≥55, from May to September 2017 in health centers of Sabzevar University of Medical. The intervention group received a solution-focused counseling and the control group received routine prenatal care. Concerns of pregnant women were evaluated before, after, and two months after the intervention using the Farsi version of Cambridge Worry Scale. The data were analyzed using t-test, chisquare, and repeated measure analysis of variance through the SPSS software version 22. A P value less than 0.05 was considered statistically significant. Results: The mean score of worry before the study was 58.9±5.9 for the intervention group and 58.8±4.37 for the control group, and no significant difference was observed. After the intervention, these values for the intervention group and the control group were 34.6±13.3 and 57.7±8.78, respectively. Two months after the study, these values were 31.1±10.1 and 54.6±10.9, respectively. The analysis of variance with repeated measurements showed that pregnant women's concerns about childbirth, fetal health, maternal health, and family relationships were significantly reduced after the intervention and two months later (P<0.001). Women's worries about socioeconomic issues were not significantly reduced after the intervention and two months later in comparison with the control group (P=0.563). Conclusion: The solution-focused counseling is an effective way to reduce pregnant women's concerns about maternal and fetal health, family relationships and childbirth. It can be used in conjunction with pregnancy care. [ABSTRACT FROM AUTHOR]

Background: Phototherapy is the most effective treatment for neonatal jaundice and intermittent phototherapy is as effective as continuous phototherapy but with fewer complications and more benefits. This study compared the hospital length of stay, duration of phototherapy and the reducing rate of total serum bilirubin after 24 and 36 hours of phototherapy in two groups. Methods: The current double-blinded randomized controlled trial was conducted on 60 icteric term neonates from November 2016 to June 2017. A total of 60 icteric term neonates were randomly divided into two groups. In the continuous group, the phototherapy device was turned on for 24 hours and in the intermittent phototherapy group, the phototherapy device was turned on for 18 hours and off for eight hours. Inclusion criteria were term neonates with non-hemolytic hyperbilirubinemia admitted to the neonatal ward of Loghman Hospital, Tehran, Iran. Infants were excluded for any of the following reasons: Hemolytic anemia, prematurity, sepsis, sever hyperbilirubinemia (total bilirubin>18 mg/dl), direct hyperbilirubinemia and onset of jaundice within the first 24 hours of life. In both arms, phototherapy continued until total serum bilirubin reached<11 mg/dL. Both early and late complications were compared including the length of hospital stay, duration of phototherapy, the rate of kernicterus, decreasing rate of serum bilirubin after 24 and 36 hours. Results: The demographic parameters did not differ significantly between the intermittent and continuous phototherapy groups. The length of hospital stay was 2.3±0.60 and 2.46±0.93 days in the continuous and intermittent groups, respectively (P=0.516) and there was not significant differences between them. The duration of phototherapy was 45.26±16.39 and 46±11.82 hours in the continuous and intermittent groups, respectively, and they had no significant differences (P=0.843). The rate of serum bilirubin cessation in the two groups was similar after 36 hours. Conclusion: According to the current study results, intermittent phototherapy was as effective as continuous phototherapy to treat icteric full-term neonates. The intermittent phototherapy also helps to maintain mother-infant bonding and it is useful to maintain breastfeeding. [ABSTRACT FROM AUTHOR]

Background: Cesarean delivery is the most common surgical procedure and this prevalence is on the rise. Given these trends, cesarean wound complications, such as disruption or infection, remain an important cause of post-cesarean morbidity. Methods: We conducted a single-center randomized controlled trial that included women with viable pregnancies (≥24 weeks) undergoing cesarean delivery at Motahary University Hospital, Urmia, Iran from April to November 2014. All cesarean types were included: scheduled or unscheduled and primary or repeat cesareans. Women were excluded for the following reasons: inability to obtain informed consent, immune compromising disease (e.g. AIDS), chronic steroid use, diabetic mellitus and BMI≥30. Of 266 women, 133 were randomized to staples and 133 women to suture group. Results: The mean±SD age of the staples group was 27.6±5.4 years and mean±SD age of suture was 28.7±5.9 years. Multiparity is the most frequent in both groups that by using Chi-square test, no significant differences were observed between the two groups (P=0.393). The most frequent indication for cesarean section in both groups was history of cesarean section in staple 40 cases (30.1%) and suture 32 cases (24.1%). The survey was conducted using the Chi-square test was not significant (P=0.381). Pain at 6 weeks postoperatively was significantly less in the staple group (P=0.001). Operative time was longer with suture closure (4.68±0.67 versus 1.03±0.07 minute, P

Background: Infertility is defined as failure to achieve pregnancy after one year of unprotected sexual intercourse. Infertility can be related to male or female factors. Varicocele is the most common cause of infertility in men that is correctable with surgery. The purpose of this study was to determine the effects of recombinant follicle-stimulating hormone (rFSH) on semen parameters in infertile men. Methods: This randomized clinical trial was done on 96 infertile men admitted to the Women's General Hospital Mohebe-Yas from September 2014 to September 2015. Inclusion criteria were to include varicocelectomy for unilateral idiopathic varicoceles and consent to participate in the study. Allergy to the drug combination and patient dissatisfaction were exclusion criteria. Patients participating in the study were divided into two groups randomly, one group received recombinant FSH three times a week and the other group received a placebo (normal saline) in the same way. After three months, the improvement of semen parameters, including motility, morphology and sperm count as well as the complications were determined in both groups. The data were analyzed with statistical software SPSS version 13 (Chicago, IL, USA). Results: A total of 96 patients were enrolled in two groups of 48 men and women; both groups were matched in terms of underlying factors. The rate of improvement in the morphology and motility of sperm in the treated group was significantly more than the placebo group (P= 0.0001); but the changes in sperm count were not significantly different between the groups (P= 0.495). Conclusion: In summary, based on the results obtained in this study, it can be concluded that recombinant FSH is effective on improving semen parameters in infertile men after varicocelectomy compared with a placebo group and its major impact is on the morphology and motility of sperm.

Background: Postoperative pain is one of the most common complications following laparoscopic cholecystectomy. Because the majority of the analgesic drugs including opioids and nonsteroidal anti-inflammatory drugs have many side effects, using drugs with lesser side effects is beneficial. The aim of this study was to evaluate the effect of N-acetylcysteine on the pain after laparoscopic cholecystectomy. Methods: In a randomized clinical trial, in two university-affiliated teaching hospitals in Babol City (Shahid Beheshti and Shahid Yahyanezhad Hospitals), Iran, from August 2015 to March 2015, a total number of 38 patients with age of 20-50 years, who were candidates for laparoscopic cholecystectomy with American Society of Anesthesiologists Class-I were chosen and randomly assigned into two groups. The night before operation, 1200 mg oral N-acetylcysteine is given to intervention group. Also, they received 600 mg IV N-acetylcysteine in the morning before operation. In the control group, two vitamin C effervescent tablets as placebo were given at night before operation and 3 ml sterile water as placebo was injected in the morning of operation. Amount of pethidine consumption and the changes in hemodynamic in two groups was recorded and analyzed at 24 hours after operation. Results: The average of patients age was not significant different between two groups (P=0.23). Average of pain score in placebo group was 3.5 and in N-acetylcysteine group was 2.7 that it was not significant difference between two groups (P=0.06). Average of pethidine consumption in placebo group was 52 mg and in N-acetylcysteine group was 29 mg in 24 hours, that the difference was statistically significant between two groups (P=0.01) Conclusion: As the results of the study, it can be concluded that the anti-inflammatory effects N- acetylcysteine can inhibit the function of lipoproteins and prostaglandins, reduced glutathione peroxidase and dismutase has been restored and can be used to treat pain or analgesic dose reduction. In this study the N-acetylcysteine has reduced pain after laparoscopy and analgesic dose of mepridine. [ABSTRACT FROM AUTHOR]

Background: Cesarean delivery is the most common surgical procedure and this prevalence is on the rise. Given these trends, cesarean wound complications, such as disruption or infection, remain an important cause of post-cesarean morbidity. Methods: We conducted a single-center randomized controlled trial that included women with viable pregnancies (≥24 weeks) undergoing cesarean delivery at Motahary University Hospital, Urmia, Iran from April to November 2014. All cesarean types were included: scheduled or unscheduled and primary or repeat cesareans. Women were excluded for the following reasons: inability to obtain informed consent, immune compromising disease (e.g. AIDS), chronic steroid use, diabetic mellitus and BMI≥30. Of 266 women, 133 were randomized to staples and 133 women to suture group. Results: The mean±SD age of the staples group was 27.6±5.4 years and mean±SD age of suture was 28.7±5.9 years. Multiparity is the most frequent in both groups that by using Chi-square test, no significant differences were observed between the two groups (P=0.393). The most frequent indication for cesarean section in both groups was history of cesarean section in staple 40 cases (30.1%) and suture 32 cases (24.1%). The survey was conducted using the Chi-square test was not significant (P=0.381). Pain at 6 weeks postoperatively was significantly less in the staple group (P=0.001). Operative time was longer with suture closure (4.68±0.67 versus 1.03±0.07 minute, P<0.001). The Vancouver scale score was significantly less in suture closure (6.6±0.8 versus 7.5±0.9, P=0.001). Wound disruption was significantly less in suture closure (3.8% versus 11.3%, P=0.017). Conclusion: The staple group had low pain and operation time but had a significant wound disruption and scar. The patients who have suffered a significant wound disruption were affected by age (P=0.022) and BMI (P=0.001) at compared those who were not affected by factors such as age or high BMI as risk factors for open surgical wound. [ABSTRACT FROM AUTHOR]

Background: Infertility is defined as failure to achieve pregnancy after one year of unprotected sexual intercourse. Infertility can be related to male or female factors. Varicocele is the most common cause of infertility in men that is correctable with surgery. The purpose of this study was to determine the effects of recombinant follicle-stimulating hormone (rFSH) on semen parameters in infertile men. Methods: This randomized clinical trial was done on 96 infertile men admitted to the Women's General Hospital Mohebe-Yas from September 2014 to September 2015. Inclusion criteria were to include varicocelectomy for unilateral idiopathic varicoceles and consent to participate in the study. Allergy to the drug combination and patient dissatisfaction were exclusion criteria. Patients participating in the study were divided into two groups randomly, one group received recombinant FSH three times a week and the other group received a placebo (normal saline) in the same way. After three months, the improvement of semen parameters, including motility, morphology and sperm count as well as the complications were determined in both groups. The data were analyzed with statistical software SPSS version 13 (Chicago, IL, USA). Results: A total of 96 patients were enrolled in two groups of 48 men and women; both groups were matched in terms of underlying factors. The rate of improvement in the morphology and motility of sperm in the treated group was significantly more than the placebo group (P= 0.0001); but the changes in sperm count were not significantly different between the groups (P= 0.495). Conclusion: In summary, based on the results obtained in this study, it can be concluded that recombinant FSH is effective on improving semen parameters in infertile men after varicocelectomy compared with a placebo group and its major impact is on the morphology and motility of sperm. [ABSTRACT FROM AUTHOR]

Background & Objectives: Recent advances in the field of intensive care have dramatically improved the survival of preterm born infants. The infants who born before 34 weeks of gestational age often have an immature or absent coordination sucking- swallowing and breathe pattern lead to feeding difficulties. In order to improve the efficacy of oral feeding in preterm infants, effective early interventions are needed. The purpose of current study is the effect of oral massage on physiological and behavioral indicators, frequency and duration of independent oral feeding in preterm infants. Materials and Methods: In this study forty-Eight Preterm infants, between 28-32 weeks of gestational age who were hospitalized in NICU were randomly divided in two groups; oral massage group and controls. Newborns in oral massage group received, pri and intraoral massages, twice per day, each time for 10 minutes before gavages at least for 10 consecutive days. Outcomes have been assessed and recorded in both groups. Results: Duration and frequency of independent oral feeding that was assessed for 5 day was significant higher in massage group (p<0.001) (p>0.002). There was no difference in Oxygen saturation, heart rate and behavioral state during oral feeding between two groups. Conclusion: Oral massage can increase both the duration and frequency of independent oral feedings in preterm infants. However it has no effect on physiological and behavioral parameters during independent oral feeding development. [ABSTRACT FROM AUTHOR]

Introduction: The report of the research results should be effectively, quickly and easily accessible to others. The most important type of medical studies in order to answer medical questions is Randomized Controlled Trial (RCT). Therefore, proper design and accurate reporting are particularly important. Objective: The aim of this study was to evaluate the published Iranian Journals abstracts using clinical list of CONSORT (taken criteria to report trials) in 2010. Materials and Methods: Eighty-eight RCT Abstracts Between 2011-2012 from 47 Journals of Iran University of Medical Sciences were evaluated in a descriptive study by two independent assessors through the CONSORT checklist which was included (referring to randomized term in the article title, full mentioning of the corresponding author details, explaining the participants selection criteria and place of data collection criteria, mentioning the applied intervention, determining the specific targets or assumptions, primary outcome expression, referring to the type of blinding, mentioning the number of participants in each group, The conditions of trials and follow-up, analysis of the number of participants in each group in terms of the primary outcome, referring to the preliminary results of the study, significant adverse events and side effects, final applied conclusion, mentioning the registration number of the clinical trial, introducing the source of the funding). Obvious referring to each case is considered as yes and any ambiguity or lack of report is considered as no. the Yes and No cases were rated by one and zero. Also, the percentage of each case was calculated as the sum of pointing Abstracts to it Than 88. A final score was given from the 18 available items in the clinical List of CONSORT abstracts to each article. The ratio of the trials which were reported each cases appropriately; was calculated with the 95% confidence intervals. Results: None of the articles mentioned all of the clinical list items completely. The maximum and minimum of the achieved scores by articles from 18 items of the clinical were, 14(%95 CI 62-100) and 5(95%CI9-60). Thirteen reported trials (14.8%) were at least <50% of the items, fifty-two articles (59.1%) were within 50-60% and twenty-three (26.1%) of them were more than 60%. About a third of cases were reported less than 20% of clinical List which were contained: mentioning the type of trial design in the title (4.5%), mentioning the number of participants in the study analysis (4.5%), recommendations of the important adverse events and side effects (6.8%), the Funding resource (9.1%), mentioning the randomization method (13.6%) and Referring to the random term in the article title (17.1%). Conclusion: The necessity of compelling the criteria at the time of writing and reviewing RCT articles will be promoted according to the results of this research. Therefore, the emphasis of the journals to the authors and reviewers based on the compliance of these criteria in reporting trials is imperative. [ABSTRACT FROM AUTHOR]