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Background: Substance abuse and the risks of its consequences are the major public health problems in the world and Iran. Objectives: The objective of the present study is determination the epidemiological status and spatial distribution of high-risk and low-risk clusters along with estimating the relative risk of drug poisoning in Semnan in 8 years. Methods: A descriptive-analytical and retrospective longitudinal study was conducted that examined all 3360 poisoned patients who referred to the hospitals of Semnan province from 2011 - 2018. The total number of visits was received and analyzed by year with the relevant diagnostic code in ICD-10 from hospitals of the province, and data were analyzed using Joinpoint regression analysis, global Moran’s index and Kuldorff's spatial statistic scan at a significant level of 0.05. Results: The number of clients varied from 219 in 2011 to 570 in 2015. The patients' mean age was 26.7 years. The average annual number of cases per one hundred thousand individuals (annual cases/100000) was 598.4. The AAPC of the incidence of drug poisoning was 9.8 and significant in the whole province, demonstrating that the incidence of poisoning increased by an average of 9.8% per year in the whole province from 2011 to 2018. Semnan County with LLR = 533.07 was the most likely low-risk cluster, and Shahroud County was the most likely high-risk cluster with LLR = 219.94. Conclusions: Drug policies need to be adapted to the geographical differences in the place death. After clustering regions in poisoning incidents, the necessary interventions can be concentrated for these specific geographical locations.

Diabetes incidence has increasingly risen in Iran and other low- and middle-income nations in recent decades. In the Semnan Greater Area of Iran, we evaluate the incidence of type 1 diabetes (T1D), type 2 diabetes (T2D), and gestational diabetes during 2015-2020 as well as their six-year trend.This is a retrospective analysis of data (n = 820401) from the Integrated Health System (sib) in Semnan province during 2015-2020. All diabetes cases with diagnostic codes based on the International Classification of Diseases 10 (ICD-10) are listed by year. The Grid Search method was used to obtain the exact number and time of points when the incidence of diseases changes significantly (Joinpoints). Average Annual Percent Change-Annual Percentage Change (AAPC-APC) values and slop changes in the estimated regression line with 95% confidence interval were utilized based on diabetes types to determine Joinpoints. P-value 0.05 is considered statistically significant.The proportions of diabetes types (T1D, T2D, and gestational diabetes) among 820401 diabetics were 4.18%, 94.84%, and 0.97%, respectively. APC value denotes that T1D has increased by 12.47% per year on average in this period (P-value 0.01). The incidence of T2D and gestational diabetes has increased between 2015 and 2020 (APC = 15.02 and APC = 136.138, respectively; P-value 0.1).In summary, the incidence of diabetes in Semnan province is constantly increasing. T2D, meanwhile, has a higher proportion. Nevertheless, gestational diabetes had the highest increase annually. Well-designed surveys investigating the reasons for diabetes increment especially gestational ones and its burden are needed.

Objectives: Aging is one of the most critical stages of human development that has its own characteristics and conditions. One of the most common issues in old age is the mental health whose achievement requires special attention from both health system policymakers and service providers to the elderly. Death anxiety is one of the most common mental health issues in old age, because this period is full of feelings of shortcomings and disabilities. Since death anxiety is a multidimensional factor, it is expected to affect many aspects of the elderly. The present study aims to review and analyze published studies in the field of death anxiety in the elderly in Iran. Methods & Materials: This is a systematic review and meta-analysis conducted on the studies related to the death anxiety of the elderly in Iran published in Persian from 2011 to 2019. A search was conducted in national databases, including SID, IranDoc, MagIran, IDML, and CIVILICA using the keywords: Death anxiety, elderly, and older adult. Initial search yielded 61 articles. After screening, 33 studies that met the entry and exit criteria were selected for the final review. We used Stata v. 14 and SPSS v. 22 applications to perform meta-analysis. Results: In the studies, 40.35% of the participants were older women and the rest were older men with a mean age of 67.80±6.44 years. The mean score of death anxiety was higher in men than in women, and the elderly living in nursing homes had the highest score (11.8). Studies were categorized into three sections: comparison (3 studies), intervention (11 studies), and factors affecting the death anxiety (18 studies). The results of meta-analysis showed no significant relationship between spiritual therapy and reduction of death anxiety in the elderly (P>0.05). In studies with spiritual and behavioral therapies, the heterogeneity was significant and, thus, a significant positive relationship was observed between the reduction of death anxiety and these treatments methods. Conclusion: The death anxiety level of the elderly in Iran is low. Religious beliefs, hopes for the intercession of imams and religious leaders, and hopes for freedom from the hardships of worldly life seem to have contributed to low death anxiety in Iran. Different death anxiety scores have been reported for older men and women in Iran may be due to the effect of culture, religion, and traditions, the difference in the roles of men and women, and even the expression of fear and anxiety. Most of men have less tendency to express their emotions, including fear, while women are more likely to express their feelings. Behavioral and spiritual interventions lead to a decrease in the elderly’s death anxiety through affecting their finding meaning in life.

Coronavirus disease (COVID-19) is a newly emerged respiratory illness, which has spread around the world. Pregnant women are exposed to additional pressure due to the indirect adverse effects of this pandemic on their physical and mental health. Since the psychological wellness framework is weak in developing countries, it is likely that geographical factors affect the prevalence. Therefore, the goal of this meta-analysis is to investigate the prevalence of anxiety and depression among pregnant women during the COVID-19 pandemic.We searched databases including PubMed/MEDLINE, Web of Science, Cochrane Library for articles. The quality of studies was determined based on the STROBE checklist. I2 and Cochrane Q-test were used to determine heterogeneity. Fixed effects and/or random effects models were also employed to estimate pooled prevalence.Since heterogeneity was fairly high in all analyses, the random effect model was used. According to the results of random effects in the meta-analysis, the pooled prevalence was 18.7% (95% CI: 0.06-0.36%;Covid-19 may impose extra pressure on the emotional wellbeing of pregnant women. Therefore, there is an urgent need for resources to help mitigate anxiety and depression in pregnant women.

Objectives This study aimed to evaluate the validity and reliability of the Persian version of Health of the Nation Outcome Scales for Elderly People (HoNOS65+) in Iran's elderly population. Methods The scale English version translated to Persian using a forward and backward translation method. The scale was filled for two elderly population groups (inpatient and outpatients) (N = 300). Simultaneously with HoNOS+65, the Clinical Global Impressions Scale (CGI) was completed. Two separate therapists were filled HoNOS+65 for thirty‐one patients (inter‐rater reliability test). In general, content validity, consistency, confirmatory factor analyses (CFA), convergent validity, and criterion validity were examined. Results Using exploratory factor analysis, three factors were extracted. Inter‐rater reliability in some items has a slight agreement. Content validity ratio (0.75) and index (0.90) were calculated for each item. Cronbach's alpha total score was 0.82. According to the largest modification indices, CFA showed satisfactory fit indices. The convergent validity between HoNOS +65 and CGI was (r = 0/71, sig = 0.000). Finally, the optimal cut‐off point was achieved 13. Sensitivity and specificity for the HoNOS +65 were 88.89% and 81.16%, respectively, with the Youden index of 0.7005. Conclusion The Persian version of HoNOS65+ has high reliability, validity, specificity, and sensitivity in multidimensional assessment of Iranian geriatric mental health., HoNOS+65 Persian version demonstrated the optimal cut‐off score at 13, which yielded a sensitivity of 88.89% and specificity of 81.16%. So those who scored higher than 13 are known patients who need psychiatric interventions. ​

Background: To decrease diabetes prevalence, society will have to make efficient policies. Objectives: This study was done to raise public awareness by estimating the incidence of type 2 diabetes mellitus (T2DM) in Semnan province from 2015 to 2020 and predicting its incidence until 2025. Methods: A Box-Jenkins time series analysis was used in this longitudinal study. The number of referrals with diabetes was estimated month by month from 2015 to 2020. The autoregressive integrated moving average (ARIMA) model parameters were determined using the Time Autocorrelation Function and Partial Autocorrelation Function graphs after using appropriate data transformation methods to create a stationary time series. Dickey-Fuller test was used to perform an accurate examination of the static assumption. ARIMA (3,1,4) was selected as the best fit for the data after analyzing the Akaike statistics of the proposed models. Finally, until 2025, the ARIMA (3,1,4) model projected the number of diabetic patients in Semnan province. Results: The total incidence of T2DM ranged by year was 75203 in 2015 and 165143 in 2020. The time series has an increasing trend, but there is no seasonal variation or periodic pattern. The data about the T2DM incidence indicated an upward trend. Furthermore, the number of T2DM patients is expected to reach 14546.35 (95% CI: 13667.88 - 15374.72) in 2021 and will reach 16956.45 (95% CI: 13499.26 - 19819.49) by the end of 2025. Conclusions: This study reported an increasing trend in T2DM incidence, which necessitates a national commitment to proactive remedies, including public policies and economic incentives for localities to begin diabetes preventive initiatives.

Job satisfaction of healthcare providers is important for their own health and also the quality of care provided to their patients. The aim of our study was to measure the chronotype patterns among healthcare providers and its association with their job satisfaction. Using stratified cluster random sampling, we recruited 210 healthcare providers working permanent morning or evening shifts for a cross-sectional study in Sari, Iran. By in-person interview, we collected data on demographic characteristics and assessed both chronotype, using the Horne-Östberg M-E Questionnaire, and job satisfaction, using the Danet's Job Satisfaction Questionnaire. We grouped job satisfaction scores into four ordinal categories and assessed correlations with study variables by ordinal multivariate logistic regression. The average age of the participants was 39.0 (SD 8.02) years. Most were younger than 45 years of age (74.27%), female (66.67%), married (62.24%), of high income (45.71%), and employed in permanent full-time healthcare work (56.67%). Overall, 63.4% of the participants had moderately high to high job satisfaction. Those who worked the morning shift who were moderate morning and high morning chronotypes, compared to those who were intermediate chronotype, had a statistically significant adjusted odd ratio (AOR), respectively, of 11.36 and 6.53 of higher job satisfaction. Likewise, those who worked the evening shift and were moderate evening and high evening chronotype, compared to intermediate chronotype, had a statistically higher AOR of job satisfaction, respectively, 3.44 and 32.63. We found the match between chronotype and work shift schedule to be linked with increased job satisfaction. If the findings are verified in other investigations, the relatively easy measure of chronotype should be considered to assign people to a work shift to improve job satisfaction of healthcare and perhaps other workers.

Background: This study aimed to assess the relationship between intimate partner violence (IPV) and quality of life (QOL) among menopausal women. Methods: The present cross-sectional study was conducted on 202 postmenopausal women admitted to different healthcare centers. The primary data collection tools were the revised Conflict Tactics Scale (CTS2) and Menopause-Specific Quality of Life (MENQOL). Results: The participants encompassed 202 postmenopausal women with the mean age of 52.14 ± 5.93 years. The analysis revealed that 70.8% of women were 45 - 55 years, 29.2% of women were 56 - 65 years, and 62.7% of the participants had more than two children. Compared to the non-smoking participants, the smoking women reported more injury violence (P = 0.008). In this study, the effect of the husband and wife’s level of education on IPV was not significant. The menopausal women or their spouses experienced more psychological (P = 0.008) and injury (P = 0.01) violence following their second marriage. The present findings suggested that three types of violence, including psychological (P < 0.001), physical (P = 0.003), and injury (P < 0.001), reported higher levels of psychological symptoms. The women experiencing psychological (P < 0.001) and sexual (P = 0.012) violence reported more severe physical problems than those with no history of violence in menopause. Conclusions: This study provided more profound insights into the relationship between menopause-related quality of life and types of violence among menopausal women. The quality of life in postmenopausal women is significantly declined under domestic violence. Healthcare providers are recommended to be trained on detecting and managing IPV and the corresponding physical and psychological problems.

Research suggests that there is an increasing trend in drug-related deaths worldwide: an estimated 69 000 individuals lose their lives due to substance abuse annually.To determine the geographical pathology of drug-related deaths in the Islamic Republic of Iran and to evaluate incidence trends, with a focus on identifying high- and low-risk regions.For this ecological study, we collected data from the 2 main sources (the Legal Medicine Organization and the Ministry of Health and Medical Education) responsible for registering substance-related deaths during 2014-2017. Data analysis was conducted using Joinpoint regression analysis, Global Moran's I and Anselin Local Moran's I.Of the 12 386 drug-related deaths in 2014-2017, most occurred during the summer months; 7162 of these were among middle-aged individuals. The mean age of children and adolescents who died of substance abuse was 5.2 [standard deviation (SD) 4.6] years. In the young adult group, mean age at death was 20.7 (SD 2.5) years; it was 34.2 (SD 5.4) years for adults and 55.6 (SD 9.8) years for older adults. Changes in mortality rate peaked in 2017 (annual percentage change = 0.52); in the last months of the study period there was a nonsignificant decrease (annual percentage change = -6.99) in the incidence (average annual percentage change = -0.5; 95% confidence interval: -3.2, 2.3).Deaths due to substance abuse will remain a huge public health problem unless policy- and decision-makers determine why this problem continues to increase despite the extensive efforts on regulation and find ways to mitigate it.التوزيع الجغرافي والاتجاه الزمني للوفيات الناجمة عن المخدرات في جمهورية إيران الإسلامية خلال الفترة من 2014 إلى 2017: دراسة بيئية.عباس عليبور، مهران زرغامي، سجاد رحیمی بوردنجانی، أردشير خسروي، مهدي صبري، مسعوده باباخانیان.تشير البحوث إلى تزايد اتجاه الوفيات الناجمة عن المخدرات في جميع أنحاء العالم، إذ يُقدَّر عدد الذين يفقدون حياتهم بسبب تعاطي مواد الإدمان بنحو 69 ألف شخص سنويًّا.هدفت هذه الدراسة إلى تحديد التوزيع الجغرافي للوفيات الناجمة عن المخدرات في جمهورية إيران الإسلامية وتق ييم اتجاهات الوفيات، مع التركيز على تحديد المناطق ذات المخاطر العالية والمنخفضة.لإجراء هذه الدراسة البيئية، جمعنا بيانات من المصدرين الرئيسيين المسؤولين عن تسجيل الوفيات الناجمة عن تعاطي مواد الإدمان (وهما مؤسسة الطب الشرعي، ووزارة الصحة والتعليم الطبي) خلال المدة من عام 2014 إلى 2017. وخضعت البيانات للتحليل باستخدام تحليل انحدار Joinpoint، وأداة Global Moran’s I وأداة Anselin Local Moran’s I.من بين 12386 حالة وفاة ناجمة عن المخدرات في الفترة من عام 2014 إلى 2017، وقعت معظم حالات الوفاة في أشهر الصيف؛ وكان 7162 شخصًا منهم في منتصف العمر. وكان متوسط عمر الأطفال والمراهقين الذين تُوفوا بسبب تعاطي مواد الإدمان 5.2 [الانحراف المعياري 4.6] سنة. وكان متوسط العمر عند الوفاة 20.7 (الانحراف المعياري 2.5) سنة في فئة الشباب، و34.2 (الانحراف المعياري 5.4) سنة في فئة الكبار، و55.6 (الانحراف المعياري 9.8) سنة في فئة كبار السن. وبلغت التغيرات في معدل الوفيات ذروتها في عام 2017 (النسبة المئوية للتغير السنوي = 0.52)، وشهدت الأشهر الأخيرة من فترة الدراسة انخفاضًا غير ملحوظ (النسبة المئوية للتغير السنوي = -6.99) في معدل الوفاة (متوسط النسبة المئوية للتغير السنوي = -0.5؛ حدود الثقة 95٪: -3.2، 2.3).ستظل الوفيات الناجمة عن تعاطي مواد الإدمان مشكلة ضخمة من مشكلات الصحة العامة، ما لم يتمكن المُشرِّعون أو المسؤولون عن الصحة العامة أو غيرهم من تحديد سبب استمرار تزايد هذه المشكلة على الرغم من الجهود المكثفة التي بُذلت حتى الآن.Distribution spatiale et tendance temporelle des décès liés à la consommation de drogues en République islamique d'Iran entre 2014 et 2017.Les recherches indiquent une tendance à la hausse des décès liés à la consommation de drogues dans le monde : selon les estimations, 69 000 personnes perdent la vie chaque année du fait de l'abus de substances psychoactives.Déterminer la pathologie géographique des décès liés à la consommation de drogues en République islamique d'Iran et évaluer les tendances de l'incidence, en mettant l'accent sur l'identification des régions à haut et à faible risque.Pour cette étude écologique, nous avons recueilli des données auprès des deux principales sources chargées de l'enregistrement des décès liés à la consommation de substances psychoactives (l'Organisation de médecine légale et le ministère de la Santé et de l'Enseignement médical) entre 2014 et 2017. L'analyse des données a été réalisée à l'aide de l'analyse de régression Joinpoint, Global Moran's I et Anselin Local Moran's I.Sur les 12 386 décès liés à la consommation de drogues enregistrés entre 2014 et 2017, la plupart se sont produits pendant les mois d'été ; 7162 d'entre eux sont survenus chez des personnes d'âge moyen. L'âge moyen des enfants et des adolescents décédés du fait de la consommation de substances psychoactives était de 5, 2 ans [écart type (ET) 4, 6]. Dans le groupe des jeunes adultes, l'âge moyen au décès était de 20,7 ans (ET 2, 5) ; il était de 34, 2 ans (ET 5, 4) pour les adultes et de 55,6 ans (ET 9, 8) pour les adultes plus âgés. Les variations du taux de mortalité ont culminé en 2017 (variation annuelle en pourcentage = 0,52) ; au cours des derniers mois de la période de l'étude, on a observé une diminution non significative (variation annuelle en pourcentage = –6, 99) de l'incidence (variation annuelle moyenne en pourcentage = –0, 5 ; intervalle de confiance à 95 % : –3, 2, 2, 3).Les décès dus à la consommation de substances psychoactives resteront un énorme problème de santé publique à moins que les législateurs, les responsables de la santé publique, etc. ne puissent déterminer les raisons pour lesquelles ce problème s'aggrave encore malgré les efforts considérables déployés en matière de réglementation et que ces derniers puissent trouver des moyens d'en atténuer l'impact.

BackgroundOutdoor activities were restricted during the COVID-19 outbreak, although digital learning grew. Concerns have been raised about the impact of these environmental changes on myopia status. This research aimed to examine myopia shift during the COVID-19 pandemic and offer the community evidence-based data.MethodsThe literature search was undertaken in PubMed, SCOPUS, Science Direct, Web of Science and Google Scholar databases on published papers before 17 May 2022. The main outcome was mean spherical equivalent refraction (SER) before, at the onset and at the end of follow-up during the COVID-19 pandemic.ResultsAmong 518 articles, 10 studies were included in the meta-analysis. The mean SER differences during the COVID-19 pandemic follow-up (mean follow-up time was 10 months) compared with before the pandemic was 0.15 dioptre (D) (95% CI −0.39 to 0.69, p=0.58). After age adjustment using meta-regression, the mean SER differences during the COVID-19 follow-up compared with before the pandemic was – 0.46 D (95% CI −0.59 to −0.34, pConclusionDuring home quarantine, the mean SRE shifting in paediatrics accelerated. This phenomenon should be given more attention by policymakers, eyecare experts, educators and parents.

Background: During the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, anxiety has always been with patients. Objectives: It is necessary to obtain a valid instrument for the evaluation and screening of patients with anxiety. The current study attempted to evaluate the sensitivity and specificity and provide the clinical cut-off scores for the Death Anxiety Scale (DAS) and Generalized Anxiety Disorder 7-Item (GAD-7) Scale in hospitalized patients diagnosed with COVID-19 in Iran. Methods: This diagnostic accuracy study was carried out for 4 months on 150 hospitalized patients diagnosed with COVID-19 to evaluate generalized anxiety disorder and death anxiety. Cronbach’s alpha was used to evaluate reliability. For the determination of the presence of anxiety disorders, the Structured Clinical Interview with hospitalized subjects was conducted by a psychiatrist based on the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition diagnostic criteria. Results: The Cronbach’s alpha coefficients for the GAD-7 Scale and DAS questionnaires were observed to be 0.88 and 0.74, respectively, confirming their reliability. Based on cut-off scores with the best balance, the sensitivity and specificity of the GAD-7 Scale questionnaire were 61.9% and 86.9%, respectively. Moreover, the sensitivity and specificity values related to the DAS questionnaire were 47.8% and 73.8%, respectively. The values for the area under the curve were 0.75 and 0.63 for the GAD-7 Scale and DAS, respectively. With this scoring method, those who scored higher than 8 and 7 in the GAD-7 Scale and DAS questionnaires were considered patients, respectively. Moreover, in these two tests, higher levels of generalized anxiety and death anxiety were reported in female patients. Conclusions: The GAD-7 Scale and DAS both showed adequate psychometric properties and diagnostic accuracy; therefore, they are applicable for anxiety screening in patients with COVID-19. It will likely take a few years to bring the virus under control worldwide. Iran’s Ministry of Health should implement exact psychological interventions during hospitalization and after discharge to prevent the adverse mental health consequences of COVID-19.

The death registration is conducted by different systems in Iran. The drug-related death registration is exclusively conducted by Ministry of Health and Medical Education (MOHME) and Legal Medicine Organization (LMO). This study investigates the causes of undercounting drug-related deaths (DRDs) in Iran, provides recommendations for addressing this issue, and provides a geographical evaluation of the integrity and quality of drug-related mortality registration (2014-2017).This is a mix-method study. In part1, individual targeted interviews were conducted with 12 experts in death registration in MOHME and LMO to collect data on the causes of low registration in Iran and provide recommendations for resolving the issue. Part2 of the study involved an intervention in the form of a memorandum of understanding on reduction of low-registrations. This memorandum was signed to transfer information about the corpses between the MOHME and LMO. First, the number of DRDs (2014- 2017) was examined using capture-recapture method and, then, we calculated and compared the rate of pre-intervention (2014-2016) and post-intervention (2017) under-registration to assess whether this memorandum of understanding had been effective in reduction of under-registrations.In part1, according to the participants, the causes of undercounting DRDs in LMO and MOHME were arranged and categorized into 4 categories: weak administration system, physician and personnel training problems, system constraints, and client-related problems. Also, some suggestions were presented to help resolving the problem of undercounting; these suggestions concern the administrative system, technology, and educational domains. In part 2, about half of the provinces in Iran had a positive performance in reducing the undercount.At the macro level, the memorandum of understanding between the two organizations responsible for registering deaths was effective. However, increasing the quality of data registrations requires monitoring at the micro and organizational levels to lead to a positive performance in reducing death under-registration in all provinces.

Introduction: Regarding the prevalence of sexual problems during menopause and the interest of women in the use of aromatherapy in attenuating the sleep disorders, and due to the lack of comprehensive meta-analysis on the effects of aromatherapy on the sleep disorders, the present study was conducted to determine the effect of lavender on the sleep disorders in postmenopausal women.Material and Methods: The following databases were selected to search systematically the effect of lavender on the quality of sleep in post-menopausal women, including PubMed, Cochrane Library, ISI Web of Science and Scopus, regardless time limit since inception to September 29, 2019. The quality of trials was investigated according to Jadad scale.Results: After combination of the result of four trials, our meta-analysis showed that treatment with lavender was more effective than placebo in respect with improvement of quality of sleep in menopausal women (Standardized Mean Difference=1.098; Confidence Interval 95%: 0.33-1.86; P= 0.005).Conclusion: Considering the effects of lavender essential oil on improving the quality of sleep in postmenopausal and middle-aged women, this medication can be prescribed in the clinics of sleep problems, obstetrics and gynecology.

Background For decades, child labor has been an important global issue associated with inadequate educational opportunities, poverty and gender inequality. In order to make effective policies to reduce child labor it is important to understand the specific factors that affect it. We aimed to investigate the main factors affecting child labor n Iran. Materials and Methods There are authoritative websites on the topic of working children in Iran, including the WHO, UNFPA, UNDP, Web of Science, ProQuest, Medline, Scopus, and CINAHL databases for reviewing studies conducted in Iran. Articles from internal dissertations and Google's databases, SID, Magiran, and Iran Doc during the period 1985 to June 2019 were included. Quality of studies was reviewed by the STROBE checklist. Information was extracted by two blind researchers. Results A total of 9 studies were identified (including 17, 219 on child labor), the majority of which were cross-sectional. Affecting factors on child labor and Street children were grouped into four categories such as "Family problems", "Urbanization", "Social and Cultural", and "Personality". Conclusion In the contemporary Iranian society, many children, for some reasons including personal, family, social and cultural, and urbanization problems, are involved with important social damages such a child labor. These factors make children vulnerable and endanger the health of the community.

Background: Today, an increasing trend to methadone as an alternative maintenance treatment for opiate dependence in adults is observed; children for both intentional and accidental reasons are exposed to serious and fetal effects of methadone. We aimed to investigate effects of methadone on children and sexual functioning among adults in Iranian population. Materials and Methods: An extensive search was done in databases of Medline, EMBASE, Scopus, Cochrane, and Web of Science until August 2018. Two independent researchers screened articles, and categorized them based on the evaluated outcomes and overall effect size was presented. After excluding the duplicated, irrelevant and low-quality articles, eligible ones were enrolled in the meta-analysis. Finally, pooled effect size was presented as standardized mean difference (SMD) or pooled prevalence with 95% confidence interval (95% CI). Results: Methadone was found to be more effective than morphine on neonatal abstinence syndrome. The first four most common symptoms of methadone poisoning were loss of consciousness (81%), sleepiness (72%), meiotic pupils (76%), vomiting (56%), and Apnea (48%). The overall prevalence rate of sexual disorders and erectile dysfunction was 66.3% and 77.5%, respectively. The subjects in methadone group were over 2.5-fold more likely to use condom during intercourse (p Conclusion: Evidence suggests a positive impact of methadone maintenance treatment on risky sexual behaviors. Regarding the methadone poisoning effect on children, people should be informed by health care providers about serious and fetal effects on children.

Background: Postpartum depression has negative effects on mother, child and family. Regarding the side effects of antidepressants and because of contradictory results on the effects of herbal medicines, the present meta-analysis was conducted to evaluate the efficacy of herbal medicines in treatment of postpartum depression and maternal-infant attachment. Materials and Methods: An extensive search was done in databases of Medline, EMBASE, Scopus, Cochrane, and Web of Science in English databases as well as IranDoc, Magiran, Medlib and SID, in Persian databases with no time limitations until November 2018. Two independent researchers screened articles, in the next step, full texts of probably relevant articles were summarized and categorized based on the evaluated outcomes and overall effect size was presented. Results: The meta-analysis of five trials showed score of depression was lower in herbal medicines group compared to placebo (Standardized Mean Difference [SMD= -0.648], 95% confidence interval [CI]: -0.849 to -0.446). Heterogeneity was non-significant (I2=0%, p=0.476). Meta-analysis of compounds containing lavender decreased score of depression significantly compared to control group. Heterogeneity was non-significant (SMD=-0.629, 95%CI: -0.847 to -0.411, I2=9.8%, p=0.34). The lavender meta-analysis of three studies showed a significant effect in comparison to control group (SMD=-0.570, 95%CI: -0.799 to -0.341; I2=9.8%, p=0.34). The aromatherapy meta-analysis showed that aromatherapy with or without massage could lead to a significant decrease in score of depression compared to control group (SMD= -0.637, 95%CI: -0.924 to -0.333; I2=66%, p=0.084). Some herbal medicines showed a significant effect on maternal-infant attachment and feelings toward baby scale. Conclusion: Herbal medicines can be considered as an alternative option in treatment of postpartum depression. Also, maternal-infant attachment and feelings toward baby scale were affected by herbal medicines.

INTRODUCTION Sex addiction is a major psychiatric disorder in which a person is compelled to participate in sexual activities despite negative consequences. This study was conducted to localize a brief sex addiction screening instrument (PATHOS) for use in the Iranian population and to determine variables predictive of sex addiction in the general Iranian population. METHODS In this study, we evaluated the psychometric properties of PATHOS in a sample of 443 Iranians in 2018. Data were analyzed using exploratory factor analysis (Factor 10.8.04 software). Simple and multiple linear regression analyses were used to investigate construct validity and variables predictive of addiction. RESULTS Exploratory factor analysis identified two factors in this dichotomous questionnaire and reported the questionnaire's test-retest reliability in the target population. Prognostic variables for sexual addiction in the Iranian population were determined to be female gender, higher education, viewing pornographic videos, having multiple sex partners, having difficulty interacting in sex, and history of masturbation. CONCLUSION The Persian version of the brief sex addiction screening instrument (PATHOS) has sufficient reliability and validity in the Iranian population. The predictive variables of sex addiction are indicative of the presence of risk of this disorder in Iranian samples and more studies are needed in order to enable prevention and treatment.

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High alcohol consumption is an important public health problem, and understanding factors associated with such consumption is essential.This study aimed to assess individual and social factors associated with alcohol consumption during the coronavirus disease 2019 (COVID-19) pandemic in the Islamic Republic of Iran.In this qualitative study, purposive sampling was used to select study participants by sharing the survey link on the Telegram application channels with an Iranian audience during COVID-19. The study was conducted from March to June 2020 and reached all Iranian provinces. We used qualitative content analysis to investigate specific concepts in the responses.Of the 116 participants who responded to the survey, 34 (29.3%) were females, and 82 (70.7%) were male. The mean age of the participants was 34.8 years (standard deviation 9.9; range 17-71 years). Most of the participants (75.9%) reported having consumed alcohol, and 56.9% reported having self-medicated for an illness without a doctor's prescription before the COVID-19 pandemic. The most common reason given for alcohol consumption was to relieve stress during home quarantining (32.3%). Based on analysis of the responses, two themes emerged: coping motivations and coping skills, with five subthemes and 14 basic codes. Coping motivations were more powerful than coping skills in relation to high alcohol consumption.Poor coping skills and strong motivations, combined with misinformation on social media and the internet, appear to have led to new or higher alcohol consumption among survey respondents.الدوافع وراء تعاطي الكحول أثناء جائحة كوفيد 19-، جمهورية إيران الإسلامية.أبو الفضل فتاح، مليحة خلوتي، مهدي أبو نوري، نادر ملوي، فاطمة أزرطاش، مسعود باباخانيان.يعد ارتفاع تعاطي الكحول مشكلة صحية عامة مهمة، ومن الضروري فهم العوامل المرتبطة بهذا التعاطي.هدفت هذه الدراسة إلى تقييم العوامل الفردية والاجتماعية المرتبطة بتعاطي الكحول أثناء جائحة مرض فيروس كورونا 2019 (كوفيد-19) في جمهورية إيران الإسلامية.في هذه الدراسة الكيفية، استُخدمت عينات مقصودة لاختيار المشاركين في الدراسة من خلال مشاركة رابط المسح عبر قنوات تطبيق Telegram مع فئة من الجمهور الإيراني أثناء جائحة كوفيد 19-. وأُجريت الدراسة في الفترة من مارس/آذار إلى يونيو/حزيران 2020، ووصلت إلى جميع المحافظات الإيرانية. واستخدمنا تحليل المحتوى الكيفي لاستقصاء مفاهيم محددة في الإجابات.من بين 116 مشاركًا أجابوا عن المسح، كان 34 منهم (29.3٪) من الإناث. وكان متوسط عمر المشاركين 34.8 سنة (الانحراف المعياري 9.9؛ النطاق 17-71 سنة). وأفاد معظم المشاركين (75.9٪) بأنهم تعاطوا الكحول، وأفاد 56.9٪ بأنهم قاموا بمداواة أنفسهم من أحد الأمراض دون الحصول على وصفة طبية من الطبيب قبل جائحة كوفيد-19. وكان السبب الأكثر شيوعًا لتعاطي الكحول هو تخفيف التوتر أثناء الحجر الصحي المنزلي (32.3٪). واستنادًا إلى تحليل الإجابات، ظهر موضوعان هما: دوافع التأقلم، ومهارات التأقلم، إلى جانب خمسة موضوعات فرعية و14 رمزًا أساسيًا. وكانت دوافع التأقلم أقوى من مهارات التأقلم فيما يتعلق بارتفاع تعاطي الكحول.يبدو أن ضعف مهارات التأقلم والدوافع القوية، إلى جانب المعلومات المغلوطة في وسائل التواصل الاجتماعي والإنترنت، أدت إلى مستوى جديد أو أكثر ارتفاعًا من تعاطي الكحول بين المشاركين في المسح.Les motivations en matière de consommation d'alcool pendant la pandémie de COVID-19 en République islamique d'Iran.Une forte consommation d'alcool représente un problème de santé publique important ; il est donc essentiel de comprendre les facteurs qui lui sont associés.L’ étude visait à évaluer les facteurs individuels et sociaux associés à la consommation d'alcool pendant la pandémie de maladie à coronavirus 2019 (COVID-19) en République islamique d'Iran.Dans la présente étude qualitative, un échantillonnage ciblé a été utilisé pour sélectionner les participants. Pour ce faire, le lien de l'enquête a été partagé sur les canaux de l'application Telegram avec un public iranien pendant la pandémie de COVID-19. L'étude a été menée de mars à juin 2020 et a couvert toutes les provinces iraniennes. Nous avons utilisé une analyse qualitative du contenu pour étudier des concepts spécifiques figurant dans les réponses.Sur les 116 participants ayant répondu à l'enquête, 34 (29,3 %) étaient des femmes et 82 (70,7 %) étaient des hommes. L'âge moyen des participants était de 34,8 ans (écart type 9,9 ; fourchette comprise entre 17 et 71 ans). La plupart des participants (75,9 %) ont déclaré avoir consommé de l'alcool et 56,9 % ont déclaré s'être automédicamentés pour une maladie sans ordonnance médicale avant la pandémie de COVID-19. La raison la plus fréquemment invoquée pour justifier la consommation d'alcool était le soulagement du stress pendant la quarantaine à domicile (32,3 %). L'analyse des réponses a permis de dégager deux thèmes : les motivations à la consommation d'alcool et les capacités d'adaptation, avec cinq sous-thèmes et 14 codes de base. Les motivations prenaient le dessus sur les capacités d'adaptation dans le cas d'une forte consommation d'alcool.De faibles capacités d'adaptation et de fortes motivations, associées à des informations erronées diffusées sur les médias sociaux et l'Internet, semblent avoir conduit à un nouvel usage de l'alcool ou à une consommation plus élevée chez les personnes interrogées.

Introduction: This study was carried out to determine the extent of prostitution and its causes among Iranian children at risk of social harm. Material and Methods: The authoritative websites on the topic of childhood prostitution performed in Iran during the period 1985 to 2019 were searched in WHO, UNFPA, UNDP, ISI, ProQuest, Medline, Scopus, CINAHL, and Google Scholar databases for reviewing studies conducted in Iran. Articles from internal dissertations and Google's databases, SID, Magiran, Google Scholar, Iran Medex and Iran Doc search engines. Upon leaving unrelated and unqualified articles, finally, seven studies were selected. Information by 2blind researchers in the form of the article title, the first author, year of research, sample size, age was included in the Excel program. Results: The search yielded a total of 1256 records. After removing duplicates, 45 documents were retained for further examination. After screening the titles and abstracts, seven papers were retained for full-text review. Based on pre-defined inclusion criteria, seven records were included in the systemic review. Many reasons for prostitution were: running away from home, sexual harassment, forced sex, presence of a child among prostitutes including family members or friends, and other reasons including the history of addiction of parents, the history of detention and imprisonment before prostitution and the responsibility of supplying them (sponsorship) gifts and prices, membership in sex offending gangs, sex trade, and sex sales. Conclusion: Violence, sexual abuse, and sexually transmitted infections, pregnancy, mental illness, involvement in child trafficking networks and substance abuse are the consequence of the experiences of these children in prostitution, therefore, it is very important that specialists and authorities should first consider heavy penalties for adults seeking sexual contact with children and key measures should be taken for the use of these children by social services.

Objective: The present study aimed to evaluate the effects of oral fennel on menopausal symptoms. Material and Methods: This double-blind, randomized, placebo-controlled trial was conducted on 50 postmenopausal women in Mashhad (Iran). Patients were randomly divided into two groups of fennel (n=25) and placebo (n=25). Measurements were performed at baseline and after three months using the Menopause-Specific Quality of Life questionnaire. Results: Both placebo and treatment groups revealed significant improvements in the hot flush score (p

Objectives: To critically assess the effect of aromatherapy on the psychological symptoms as noted in the postmenopausal and elderly women. Methods: Three following databases were systematically searched: MEDLINE, Scopus and Cochrane Library (Cochrane Central Register of Controlled Trials) from inception to January 2018. The search keywords included ‘menopause’ AND (aromatherapy), without language restrictions. Results: In this study, 4 trials were included which fit into our systematic review. The findings demonstrated that the aromatherapy massage have significantly improved psychological symptoms in menopausal and elderly women as compared to the control group (standardized mean difference [SMD] = -1.24; 95% confidence interval, -0.188 to -0.606; P < 0.001 random effect model; 3 trials, moderate to high heterogeneity, I2 = 0.76; P = 0.028). According to 1 of the trials, the aromatherapy oil massage was no more effective than the untreated group regarding their experience of symptoms such as nervousness. Conclusions: The aromatherapy may be beneficial in attenuating the psychological symptoms that these women may experience, such as anxiety and depression, but it is not considered as an effective treatment to manage nervousness symptom among menopausal women. This finding should be observed in light of study limitations. (J Menopausal Med 2018;24:127-132)

Objectives The present trial aimed to assess the effects of Fennel (Foeniculum vulgare Mill.) on lipid profiles. Methods In this double blind, randomized and placebo-controlled trial, sixty eligible postmenopausal women were randomly assigned into the fennel and placebo groups. Total blood cholesterol, cholesterol fractions, and triglycerides were tested at the baseline, and after three-month follow-up. Results There was no significant difference in triglyceride (P = 0.679), total cholesterol (P = 0.103), low-density lipoprotein cholesterol (LDL-C; P = 0.146) and high-density lipoprotein cholesterol (HDL-C; P = 0.266) levels between the two groups. In addition, in both groups, a paired t.test showed no significant difference in all mentioned parameters, except for HDL-C, indicating significant borderline improvement (P = 0.052) in the fennel group. Conclusions The fennel group revealed a very slight positive change in LDL-C, triglyceride and HDL-C. Further studies with longer durations, higher doses, and larger sample sizes are recommended to validate the results.

The goal of this study was to compare the effect of Anethum graveolens (dill) vaginal suppositories and 100 mg clotrimazole vaginal tablets on vulvovaginal Candidiasis. This study was a single centre, single-blind, randomised, placebo-controlled trial, in which 60 women with microbiology-confirmed vulvovaginal candidiasis were randomly assigned to dill and clotrimazole groups. At the end of the study, the estimated prevalence of leucorrhoea, burning, and itching was 23%, 23% and 20% in dill users, respectively. This figure was 20%, 10% and 16.7% for the clotrimazole group, respectively. The difference between the two groups was not significant. 13% of suppository patients, compared with 10% of clotrimazole-treatment patients, had a positive culture, which was not significant (p = .68). According to findings, 2% dill vaginal suppositories were as effective as clotrimazole vaginal tablets in reducing both clinical and microbiological symptoms of Candidiasis. Studies with larger sample sizes are required to confirm current findings. Impact statement What is already known on the subject? Based on results from in vivo and in vitro animal studies, dill (Anethum graveolens) has anti-candida activity. What do the results of this study add? It appears that 2% dill vaginal suppositories were as effective as 100 mg clotrimazole vaginal tablets in reducing both the clinical and microbiological symptoms. What are the implications of these findings for clinical practice and further research? Obstetricians and gynaecologists can offer dill as a useful alternative to chemical drugs, especially in women who are often interested in herbal medicine, or in women who are resistant or are not allowed to use antifungal drugs. KEYWORDS: Anethum graveolens; clotrimazole; vulvovaginal candidiasis

Objectives The goal of this study was to evaluate the effect of fennel on body composition. Methods This study is a secondary analysis of a double-blind, randomized, placebo-controlled trial. Fifty-four out of 60 patients were able to successfully complete the original study. Seven out of 54 patients were excluded because they were not overweight and obese. Thus, 47 women were included in this secondary analysis. Of these 47 women, 22 were in the fennel group and 25 were in placebo group. Body weight, body mass index (BMI) as well as fat distribution was measured at the baseline and after a three-month follow-up. Results Comparison of fennel and placebo groups did not reveal any significant effect in terms of body weight, BMI, waist and hip circumferences and fat distribution. Also, the results of paired t-test did not variation of these parameters across groups before and after 12-week treatment. Conclusions Menopausal women in fennel group experienced a slight increase in body weight and fat distribution, which was not significant. Further studies with larger sample sizes are recommended to validate the results of this study.