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Background and Objectives: Intrauterine insemination (IUI) is one of the methods of infertility treatment. When is the best time to do this assisted reproduction procedure? There are many Islamic narrations about the appropriate time for fertilization in order to give birth to a physically, mentally, and spiritually healthy child. Therefore, this study examined the relationship between the time of IUI performance and its consequences according to Islamic narrations. Methods: The present historical cohort study was conducted at an Infertility Center affiliated with the Academic Center for Education, Culture, and Research of Qom, Iran using the medical records of patients who underwent sex selection IUI procedure from 2011 to 2015. The data were collected using a researcher-made checklist consisting of demographic characteristics, factors affecting the pregnancy outcome in terms of medicine and narrations, as well as the pregnancy outcome. The collected data were analyzed in SPSS software (version 20). Results: The findings indicated that the time of IUI performance based on Islamic recommendations and the pregnancy test result had a significant relationship (P=0.003). Moreover, the time of IUI based on Islamic recommendations had a significant relationship with pregnancy outcomes (P=0.023). The highest number of abortions and neonatal disorders were observed in pregnancies that had happened at the disapproved times according to the narrations (e.g., the end of the lunar month and when the moon is in Scorpio). Besides, the highest number of births of healthy infants happened when the insemination had happened at the recommended times (e.g., Thursday noon). Conclusion: Due to the relationship between the time of IUI based on Islamic recommendations and the pregnancy outcome, it is recommended that IUI be performed based on Islamic recommendations and at times other than the disapproved times so that better results will be achieved in pregnancy. However, further studies are needed in this regard.

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Menorrhagia is a regular menstrual cycle lasting more than seven days and/or blood loss over 80 mL per cycle. One of the herbs recommended in Iranian traditional medicine for menorrhagia treatment is lentil savigh, which is the flour made from roasted lentil (Lens culinaris medic).The current randomized clinical trial was conducted on 54 patients within the age range of 18 to 50 years randomly divided into two groups. The treatment group took three 10-gram lentil savigh sachets in the morning. The control group was treated with 500 mg tranexamic acid capsule every eight hours, both from the first day of menstruation for seven days. Patient's bleeding was evaluated by the pictorial blood loss assessment chart (PBAC), before and in each of the three treatment cycles. Quality of life was evaluated by the menorrhagia questionnaire (MQ) at the beginning and the end of the study for each patient.The mean (SD) of PBAC scores significantly decreased before and after three cycles from 383.5(163) to 222.1(128.6) in the lentil savigh group (P 0.0001), and from 333.8(141.3) to 239.1(132.6) in the tranexamic acid group (P 0.0001). There was no significant difference between the two groups (P 0.6). Quality of life significantly improved in the lentil savigh group from 61.5(12.3) to 34.4(14.6) in comparison with that of the tranexamic acid group changing from 56.3(11.1) to 46.8(12.7) (P 0.004).Both products were effective in menstrual bleeding reduction, but lentil savigh improved the quality of life more effectively. Therefore, lentil savigh, as a functional food, could be introduced as a good initial choice for menorrhagia treatment.

Background Spirituality is recognized as an important issue in health care, and every individual has spiritual needs. Despite increased knowledge about spiritual care and its necessity, there is no unique agreed-upon framework for spiritual care among the practitioners. This study aimed to explore the concept from the viewpoint of both health-care providers and patients within the Iranian social, cultural and overall contexts and present a charter for providing spiritual care. Methods The first phase of the study was a systematic literature review. The next phase consisted of two qualitative studies on the components of spiritual care from the perspective of healthcare providers and its dimensions as perceived by patients. The findings were then integrated to make up a charter draft that was accredited through expert opinion. Results The review of literatures led to the identification of two main themes and 10 themes. Perspectives of health-care providers were categorized into four main themes and 10 themes, and patients’ opinions were classified into three main themes and 11 themes. The themes and their subthemes were integrated to build the concepts and form the proposed charter with 30 statements. Conclusion The charter of spiritual care for patients is intended to present an agreed-upon framework for spiritual care delivery and resolve some of the problems in this path. This can improve health-care delivery system.

The article's abstract is not available.

Background and Objectives: Philosophy of medicine as a field of study mainly concentrates on issues, such as ontology, epistemology, axiology, and logic. Although axiology has attracted more attention due to its position in medical ethics, especially in relation to modern medical ethical challenges, other topics of philosophy of medicine should be also considered important and necessary. Developing training courses at prestigious universities, publication of journals and books, holding conference meetings, are indicative of special attention to this relatively new field of knowledge. Some stipulated goals of Iran medical education system, such as critical thinking and problem solving skills, have also made these issues important and necessary to be paid attention to. Addressing philosophy of medicine in medical education program, can lead to contemplation on critical thinking, nature of rational thinking, its governing rules, and its role in health care system, and this is while, medical education system has taken distance from combination of wisdom and medicine, which is the main feature of former and influential Iranian physicians. Graduates of medical education system and provider of health services need to know the principles of health anthropology and the nature of health and disease in order to consider humans to be more than a body and to possess special dignity, and apply their professional practices and behaviors according to this approach. It seems that presenting the mentioned issues as a course entitled "Introduction to Medical Philosophy" to the medical students, may changes the attitude of health care providers. &nbsp

Background Spiritual care is one of the important and essential aspects of healthcare. The impact of spirituality on healing, health-related states, and the ability to cope and adapt to the disease is undeniable. Thus, this study is aimed to explain the perception of the spiritual care of patients by health-care providers. Materials and methods The present study was performed with a qualitative approach using content analysis by the conventional method in hospitals of Qom University of Medical Sciences. The data were collected through in-depth semi-structured interviews with 11 participants through a purposeful sampling method and analyzed simultaneously. The consistency of the data was confirmed by the participants. Results Data analysis provided four main categories as follows: "Observing the patient's rights" with subcategories of respect, right to choose, preserving the patient's privacy, proper communication with the patient, "professionalism" with subcategories of responsibility, acceptance of mistakes, development of technical skills and knowledge, "supportive behaviors" with subcategories of paying attention to emotional and psychological needs and "Strengthening the patient's religious dimension" with subcategories of honoring religious beliefs and providing healthcare along with trust in God. Conclusions According to the study findings, spiritual care from the perspective of health-care providers was explained as attention to emotional and psychological needs, reverence for patients' religious beliefs, respect for human dignity, and sense of responsibility.

Background.Increased insulin resistance is an extragastrointestinal manifestation ofHelicobacter pylori(HP) infection. HP changes the level of inflammatory markers and cytokines and changes the adipocyte function by altering the adiponectin level. Given the high prevalence of HP and diabetes in our society, we evaluated the association between HP and serum adiponectin level. In this cross-sectional study, 211 diabetic patients under treatment other than insulin were studied. These patients were divided into two groups of HP+ and HP− based on their HP IgG antibody serology and their blood adiponectin levels were measured. Data was analyzed using independentt-test, Chi-square test, and Fisher’s exact test.Results.Seventy-two patients with an average age of51.56±8.34years were HP− and 139 patients with an average age of50.35±9.01years were HP+. The mean serum adiponectin level in HP− and HP+ groups was4.54±5.43and5.64±3.88 ng/mL, respectively. Insulin resistance degree was significantly higher in HP+ group (HP− =3.160±3.327versus HP+ =4.484±3.781,P=0.013) but no significant difference was found between the mean serum adiponectin level in HP− and HP+ groups (P=0.140).Conclusions.Although the insulin resistance degree was significantly higher in HP+ diabetic patients, no significant relationship was found between HP infection and serum levels of adiponectin.

The purpose of this study was to examine how ethical approval and competing interests are addressed by medical journals in Iran. In a cross-sectional study, 151 journals accredited by the Publications Commission of the Ministry of Health and Medical Education were reviewed. Data collection was carried out by assessing journal guidelines and conducting structured phone interviews with journal managers, focusing on how ethical considerations and conflicts of interest (COI) are addressed. Overall, 135 of the 151 journals (89.4 percent) examined some aspect of ethical considerations of submitted articles. Authors were required to disclose their financial sponsors by 98 journals (64.9 percent), while COI disclosure was required by 67 journals (44.4 percent). We conclude that the rate of addressing ethical considerations is not far from ideal, but the requirement for COI disclosure needs more attention.

Background Hepatitis D virus (HDV) is a defective RNA virus that depends on the hepatitis B surface antigen (HBsAg) of hepatitis B virus for its replication, developing exclusively in patients with acute or chronic hepatitis B. There are little data regarding the routes of HDV transmission in Iran. The risk factors for HDV infection in Iran are blood transfusion, surgery, family history, Hejamat wet cupping (traditional phlebotomy), tattooing, war injury, dental interventions, and endoscopy. Objectives We performed this study to determine the prevalence of hepatitis D in the general population of Qom province and the potential risk factors for acquiring HDV. Patients and methods This cross-sectional study collected 3690 samples from 7 rural clusters and 116 urban clusters. HBs antigen was measured, and if the test was positive, anti-HDV was measured. Ten teams, each consisting of 2 trained members, were assigned to conduct the sampling and administer the questionnaires. The data were analyzed using SPSS. Results Forty-eight subjects (1.3%) suffered from hepatitis B, and 1 HBsAg-positive case had HDV infection. The prevalence of hepatitis D infection in Qom Province was 0.03%. The prevalence of hepatitis D infection in HBsAg-positive cases was 2%. Our anti-HDV-positive case had a history of tattooing, surgery, and dental surgery. There was no significant relationship between tattooing, surgery history, or dental surgery and hepatitis D infection. Conclusions The prevalence of hepatitis D in Qom is the the lowest in Iran, similar to a study in Babol (north of Iran).

Background Hepatitis B is the most common chronic viral infection in humans and the most common cause of death among viral hepatitis. As 70% to 80% of chronic hepatitis cases are caused by HBV in Iran, this virus alone is considered the most important cause of liver diseases and the major cause of mortality arising from viral hepatitis cases in Iran. Objectives We planned this study to determine the prevalence of hepatitis B in the general population of Qom, central Iran. Patients and Methods The present study is a cross-sectional study. A total of 3690 samples were collected from 7 rural clusters and 116 urban clusters. Ten teams, each consisting of 2 trained members, were assigned to conduct the sampling and fill the questionnaires. The data were analyzed using SPSS. Results The prevalence rate of hepatitis B infection in Qom Province was 1.3%. The mean age of the patients with hepatitis B was 44.17 years. The prevalence of hepatitis B was 1.6% in men and 1.1% in women. Moreover, the prevalence of hepatitis B correlated positively with age, tattooing, and literacy level. Conclusions The prevalence rate of hepatitis B in Qom is 1.3%. It is possible to prevent the disease by increasing public awareness. Further investigation on clinical presentations and a determination of the genotype of the virus are suggested.

Mohammad K Moslemi1, Seyed M Moosavi Movahed2, Akram Heidari3, Hossein Saghafi2, Mehdi Abedinzadeh41Department of Urology, 2Department of Nephrology, 3Department of Health, Kamkar Hospital, Qom University of Medical Sciences, Qom, Iran; 4Department of Urology, Moradi Hospital, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, IranBackground: Unrestricted antibiotic use is very common in Iran. As a result, emergence of resistant organisms is commonplace. Antibiotic prophylaxis in surgery consists of a short antibiotic course given immediately before the procedure in order to prevent development of a surgical site infection. The basic principle of prophylaxis is to maintain effective concentrations of an antibiotic active against the commonest pathogens during the entire surgery.Materials and methods: We prospectively investigated 427 urologic surgery cases in our department between August 2008 and September 2009 (Group1). As reference cases, we retrospectively reviewed 966 patients who underwent urologic surgery between May 2004 and May 2008 (Group 2) who were administered antibiotics without any restriction. Prophylactic antibiotics such as cefazolin were administered intravenously according to our protocol. Postoperative body temperature, peripheral white blood cell counts, urinalysis, and urine culture were checked.Results: To judge perioperative infections, wound condition and general condition were evaluated in terms of surgical site infection, as well as remote infection and urinary tract infection, up to postoperative day 30. Surgical site infection was defined as the presence of swelling, tenderness, redness, or drainage of pus from the wound, superficially or deeply. Remote infection was defined as occurrence of pneumonia, sepsis, or urinary tract infection. Perioperative infection rates (for surgical site and remote infection) in Group 1 and Group 2 were nine of 427 (2.6%) and 24 of 966 (2.5%), respectively. Surgical site infection rates of categories A and B in Group 1 were 0 and two (0.86%), respectively, while those in Group 2 were 0 and five (0.92%), respectively. There was no significant difference in infection rates in terms of remote infection and surgical site infection between Group 1 and Group 2 (P = 0.670). The amounts, as well as the prices, for intravenously administered antibiotics decreased to approximately one quarter.Conclusion: Our protocol effectively decreased the amount of antibiotics used without increasing perioperative infection rates. Thus, our protocol of prophylactic antibiotic therapy can be recommended as an appropriate method for preventing perioperative infection in urologic surgery. Keywords: surgical site infection, antibiotic prophylaxis, single dose, urologic surgery

Abnormal uterine bleeding (AUB) is a common cause of referral to the gynecology clinic. Portulaca oleracea L., commonly named purslane, is used in Iranian folk medicine to treat AUB. To verify this use, ten premenopausal women with AUB comprising menorrhagia, metrorrhagia, polymenorrhea and intermenstrual bleeding who had not responded to standard drugs and were candidates for hysterectomy participated in the clinical trial. Endometrial biopsies demonstrated the etiologies of AUB in six (60%) patients, fibroma; one (10%) patient, endometrial hyperplasia and one (10%) patient, endometrial cyst. Endometrial biopsies of two (20%) subjects were normal. The subjects took 5 g of purslane seeds powder in a glass of water every 4 h orally 48 h after the onset of menstruation for 3 days. The participants were requested to report the effects of seeds powder on the volume, duration and pattern of bleeding. Eight (80%) patients reported that the duration and volume of bleeding had reduced and their patterns of periods had normalized. The seeds powder was ineffective in two (20%) patients. One of the patients had endometrial hyperplasia and the other had fibroma. No adverse effects were reported. AUB did not recur in the patients responding to treatment for the duration of a 3 months follow-up. The results suggest that purslane seeds could be effective and safe in the treatment of AUB.

Background: Uric acid, a product of purine degradation, is a risk factor for cardiovascular disease. Studies have demonstrated a relationship between uric acid and increased inflammatory and oxidative stress in the general population. Recent studies also confirmed the role of inflammatory factors and oxidative stress in atrial fibrillation (AF). Objectives: The purpose of this study was to investigate the relationship between serum uric acid levels and the risk of AF. Patients and Methods: This case-control study consisted of 32 patients with AF and 32 healthy controls. Both groups were matched by age, sex, and underlying disease. The diagnosis of AF was based on an electrocardiogram and confirmed by a cardiologist. Patients with heart failure, coronary artery disease, recent infection, renal failure, thyroid disorders and malignancy or who were treated with drugs affecting serum uric acid were excluded. The uric acid levels in both groups were measured using an enzymatic method. The mean serum uric acid of the two groups was compared with a t-test and SPSS software. Results: The female to male ratio in the two groups was 1.28. The mean age of the patients in the AF group and control group was 69.12 ± 11.8 and 67.75 ± 14.8, respectively. There were no significant differences in the age and sex of the two groups. The mean serum uric acid in the AF group and control group was significantly different (5.79 ± 1.19 mg/dL and 4.81 ± 1.26 mg/dL, respectively; P = 0.002). Conclusions: The results suggest that serum uric acid can be considered a risk factor for AF. Further studies are recommended to investigate the role of uric acid reduction in the prevention and treatment of AF.

Objective Cytomegalovirus (CMV) and/or Epstein-Barr virus (EBV) infections in renal transplant recipients may cause significant morbidity and mortality. To manage these infections, established guidelines suggest that both the recipient and the donor be routinely tested for anti-CMV and anti-EBV antibodies prior to renal transplantation. The aim of this study was to assess the value of screening among people living in Iran. Patients and Methods We retrospectively analyzed the incidences of CMV and EBV infections among 925 and 710 potential renal allograft donors and recipients, respectively, between 2005 and 2008. All cases were first transplantations. Enzyme-linked immunosorbent assays (ELISA) were performed to determine whether there were antibodies to CMV (IgG) or EBV viral capsid antigen (VCAIgG). Finally, we analyzed the seroprevalence and demographic factors. Results Five hundred sixty-eight (61.40%) potential renal transplant donors and 483 (68.02%) potential renal transplant recipients were men. Donor ages ranged from 18 to 50 years (mean ± SD, 34.7 ± 8.1 years) and recipient ages ranged from 18 to 60 years (mean ± SD, 45.9 ± 7.3 years). Pretransplant CMV (IgG) and EBV (VCAIgG) seroprevalence was 100% among all donor, and recipient ages and sexes. Conclusion Our findings suggested that kidney transplant centers in Iran do not need to perform routine screening for IgG antibodies to CMV and EBV among renal transplant recipients and donors of ages ≥18 years.

Introduction Fair allocation of donor organs is essential to maintain public trust in a public healthcare system. A study of the public's views and opinions of this could clarify non-medical prioritization criteria. We report our survey of public opinion of criteria for donor kidney allocation. Methods This was a cross-sectional study using random digit dialing to phone interview 706 Tehran residents. Patient scenarios were presented to determine interviewee opinions on nine recipient criteria: probability for survival, previous transplant history, time on the waiting list, age, an individual's role in developing their kidney failure, gender, marital status, social status, and financial situation. Each scenario introduced two patients and interviewees then chose the better candidate for transplantation. Results More than 50% of the participants chose length of waiting time, a patient's role in causing their disease, age, and survival time after transplantation as important allograft allocation criteria. Conclusion This study disclosed other criteria in addition to the likelihood for successful transplantation—the patient's role in the development of their disease and patient age—which should be prioritization considerations.