Effectiveness of Persian Golnar on Excessive Menstrual Bleeding in Women with Abnormal Uterine Bleeding, Compared to Tranexamic Acid: A Triple-Blind, Randomized Equivalence Trial.

Introduction: Abnormal uterine bleeding (AUB) is a major healthcare problem in females of reproductive age and impacts women's health and quality of life (QoL). This study aimed to test the equivalence of Persian Golnar (PG) and tranexamic acid (TA) for the treatment of excessive menstrual bleeding. Method: A triple-blind randomized equivalence trial with parallel design and block randomization technique was performed. A total of 80 patients with AUB were randomly allocated to receive either PG or TA for three consecutive menstrual cycles. Blood loss was measured by the Pictorial Blood Loss Assessment Chart (PBAC). Hematological evaluations were done before the intervention and after treatment. QoL and premenstrual dysphoric disorder (PMDD) as secondary outcomes were assessed using the menorrhagia questionnaire (MQ) and Premenstrual Symptoms Screening Tool (PSST). Statistical analysis was performed using an independent t-test, paired t-test, χ2 test, Mann-Whitney test, and Wilcoxon signed-rank test. Results: Seventy-six women completed the 12-week follow-up. Both PG and TA groups experienced a significant reduction in blood loss. Furthermore, the serum level of hemoglobin in the PG group enhanced significantly (P < 0.001). QoL and PMDD scores were significantly improved in both groups (P< 0.001). Conclusion: The findings of the current trial supposed that the Golnar product is as effective as tranexamic acid in controlling bleeding and enhancing the quality of life and premenstrual symptoms.

Comparison of the effectiveness of Dienogest with medroxyprogesterone acetate in the treatment of pelvic pain and recurrence of endometriosis after laparoscopic surgery.

PURPOSE: The aim of this study was to compare the effects of Dienogest and medroxyprogesterone acetate (MPA) on the recurrence of endometriosis lesions and clinical symptoms in women undergoing laparoscopic surgery. METHODS: This single center clinical trial was conducted among 106 women with endometriosis undergoing laparoscopic surgery who candidate receiving post-surgery hormone therapy. Participants were allocated to two groups. The first group received Dienogest pills (2 mg) daily for the first three months and then cyclic for three months afterward. The second group received MPA pills twice daily (10 mg) for three months and then cyclic for the next three months. Six months after the intervention, the rate of endometriosis recurrence, the size of endometriosis lesions and pelvic pain were assess and compared between two groups. RESULTS: Finally, data were evaluated based on 48 and 53 women in the Dienogest and MPA groups, respectively. After 6 months follow-up assessments the pelvic pain score was significantly lower in Dienogest group than MPA group (P < 0.001). There was not statistically difference between two groups in terms of recurrence rate of endometriosis (P = 0.4). Although the size of endometriosis cyst recurrence was smaller in Dienogest group compared to MPA group (P = 0.02). CONCLUSIONS: The findings showed that Dienogest treatment has better effect in reducing pelvic pain and the mean size of the recurrent endometriosis lesions after endometriosis laparoscopic surgery when compared to MPA treatment. Although the recurrent rate of endometriosis was similar between these treatments.

Women Participation in Health Research of Iran: Analysis of Challenges and Strategies with Literature of Review.

Background: Recent evidence provides the facts behind the perceptions about women researchers participating in health research (HR). Women scientists as almost half of active researchers in HR fields have important and fundamental role. The present study aimed to analyses the situation of women participation in HR of Iran. Methods: The present study comprised three complementary phases intended to identify and analysis challenges and problems of women participation in health research in Iran (2021-22). Following a review phase, using the content analysis approach through semi-structured interviews data gathered from key stakeholders of health research. At final step, aimed to aggregate and conclude the main key findings, through an expert panel all of the results analyzed to clarify the main messages of the study, focus on reflection to the target group. Results: The results reveal considerable gender differences in research contribution between Iranian men and women. The need for legal infrastructure and support for the active participation of women in HR was the main extracted point of study. The need for transparent documentation and implementation of related research that demonstrates the necessary challenges and gaps was another major point. Conclusion: Findings may help illuminate policy makings to promote participation of women in the country research. The optimal management of HR require facilities can play an important role in improving the quality and quantity of health studies and achieving scientific competitive positions at the regional and global levels.

The Effect of Sildenafil on Pregnancy Outcomes in Pregnant Women With Idiopathic Borderline Oligohydramnios: A Randomized Controlled Trial.

Objective: Borderline oligohydramnios always produces a dilemma of management and counseling among obstetricians. This study was designed to compare the effect of sildenafil plus fluid therapy versus fluid therapy alone on pregnancy outcomes and AFI improvement in pregnant women complicated by idiopathic borderline oligohydramnios. Materials and methods : This randomized clinical trial was conducted in Arash Women's Hospital, Tehran, Iran from 2017 to 2020. Fifty-one pregnant women with idiopathic borderline oligohydramnios were allocated to two groups. Group 1 received fluid therapy and Group 2 received fluid therapy and Sildenafil 25 mg three times daily for six weeks. AFI was measured at the time of randomization, 24 h after treatment and then weekly for six weeks. The changes in AFI, type of delivery, gestational age at delivery, and neonatal outcomes were compared between the two groups. Results: After the intervention, the change in AFI between two groups was not statistically significant. Maternal and fetal outcomes are compared between two groups and there was no significant difference between them. The median (Inter-quartile range) AFI after intervention, in Sildenafil group compared with hydration group, were in 24 hours (8.5 vs. 8, p=0.27), first (9.5 vs. 9.1, p=0.74), second (9 vs 10, p=0.12) third (10.4 vs. 9.4, p=0.33), fourth (10.8 vs 9.1, p=0.1) and Fifth week (10 vs 9.3, p=0.5) of follow-up respectively, but none of them were statistically significant. Conclusion: The findings showed that sildenafil plus fluid therapy do not improve the pregnancy outcomes in women with isolated borderline oligohydramnios compared to fluid therapy alone.

The Effect of Green Coffee Supplementation on Lipid Profile, Glycemic Indices, Inflammatory Biomarkers and Anthropometric Indices in Iranian Women With Polycystic Ovary Syndrome: A Randomized Clinical Trial.

Polycystic ovary syndrome (PCOS) is a heterogeneous clinical syndrome. Recent studies examine different strategies to modulate its related complications. Chlorogenic acid, as a bioactive component of green coffee (GC), is known to have great health benefits. The present study aimed to determine the effect of GC on lipid profile, glycemic indices, and inflammatory biomarkers. Forty-four PCOS patients were enrolled in this randomized clinical trial of whom 34 have completed the study protocol. The intervention group (n = 17) received 400 mg of GC supplements, while the placebo group (n = 17) received the same amount of starch for six weeks. Then, glycemic indices, lipid profiles, and inflammatory parameters were measured. After the intervention period, no significant difference was shown in fasting blood sugar, insulin level, Homeostasis model assessment of insulin resistance index, low-density lipoprotein, high-density lipoprotein, Interleukin 6 or 10 between supplementation and placebo groups. However, cholesterol and triglyceride serum levels decreased significantly in the intervention group (p < 0.05). This research confirmed that GC supplements might improve some lipid profiles in women with PCOS. However, more detailed studies with larger sample sizes are required to prove the effectiveness of this supplement.

Scientific Evaluation of Medicinal Plants Used for the Treatment of Cervicitis (Qorohe- Rahem) in Iranian Traditional Medicine.

Cervicitis is an inflammatory condition of the cervix associated with upper genital tract infection and reproductive complications. Treatment for cervicitis in conventional system is the use of antibiotics and antifungal therapies and surgical interventions, but none of these treatments provides the definite efficacy in spite of high cost and side effect. So there is a need for an alternate therapy which is safe, effective, easily available and free from side effects. This review focuses on medicinal plants mentioned in main Iranian Traditional Medicine reference books. Medicinal plants mentioned in Iranian Traditional Medicine for treatment of Cervicitis were elicited and searched in electronic databases including Pub Med, Scopus, Science direct and Google Scholar to find studies that confirmed their efficacy. The findings included 31 plants belonging to 21 families. Research findings showed that the plants mentioned in Iranian Traditional Medicine resources can contribute to the recovery and treatment of cervicitis through anti- inflammatory, antioxidant, antibacterial and anti- fungal, wound healing and analgesic effects. Finding the medicinal plants effective on cervicitis based on ITM could suggest a better strategy for relieving and management of cervicitis symptoms especially in recurrent or persistent condition.

Facilitating factors of self-care among HIV-positive young women in Iran: a qualitative study.

Background Providing care for chronic disease such as HIV is a growing challenge in the world. In order to address the challenges of linkage and care in chronic disease management, we need to identify factors that can influence people to get more involved in self-care. This study was part of an extensive qualitative study conducted in Tehran, Iran in 2016. Methods The data were collected through semi-structured interviews conducted on 25 women with HIV, and were analyzed using grounded theory. Four main themes were identified as facilitating self-care among participants: health system support, clinicians' support, family support and improved life expectancy. Sub-themes that emerged were free HIV tests; free medication; free membership in positive clubs; free psychological consultation; positive attitudes and friendly behavior from clinic staff; telephone follow up; support from husbands, mothers and peers; hope for recovery; hope for the future; and love for own children. Results Our results showed that, providing appropriate support and services, as well as a positive attitude of society towards HIV positive women, can contribute to adherence to self-care in young women with HIV. Conclusion Understanding the facilitating factors based on the patients' experiences can contribute to the development of new policies and procedures to improve the care of these patients.

Evaluation of Bacteriological and Chemical Quality of Dialysis Water and Fluid in Isfahan, Central Iran.

BACKGROUND: Chemical and microbial quality of water used in hemodialysis play key roles in a number of dialysis-related complications. In order to avoid the complications and to guarantee safety and health of patients therefore, vigorous control of water quality is essential. The objective of present study was to investigate the chemical and bacteriological characteristics of water used in dialysis centers of five hospitals in Isfahan, central Iran. METHODS: A total of 30 water samples from the input of dialysis purification system and dialysis water were analyzed for chemical parameters. Heterotrophic plate count and endotoxin concentration of drinking water, dialysis water and dialysis fluid of 40 machines were also monitored over a 5-month period in 2011-2012. RESULTS: Concentration of the determined chemicals (copper, zinc, sulfate, fluoride, chloramines and free chlorine) did not exceed the recommended concentration by the Association for the Advancement of Medical Instrumentation (AAMI) exclude lead, nitrate, aluminum and calcium. Furthermore, the magnesium; cadmium and chromium concentration exceeded the maximum level in some centers. No contamination with heterotrophic bacteria was observed in all samples, while the AMMI standard for endotoxin level in dialysis fluid (<2 EU/ml) was achieved in 95% of samples. CONCLUSION: Dialysis water and fluid failed to meet the all chemical and bacteriological requirements for hemodialysis. To minimize the risk of contaminants for hemodialysis patients therefore, a water quality management program including monitoring, maintenance and development of water treatment system in hemodialysis centers is extremely important. In addition, an appropriate disinfection program is needed to guarantee better control of bacterial growth and biofilm formation.

The comparison of plasma D-dimer levels in benign and malignant tumors of cervix, ovary and uterus.

BACKGROUND: Thromboembolism is the most important complication of cancers.The aim of this study was to determine D-dimer levels in benign and malignant tumors of the uterus, ovary and cervix. SUBJECTS AND METHODS: This was a cross sectional study and it was conducted on 90 female patients referred to Imam Khomeini and Arash Hospitals because of uterine, cervical and ovarian tumors in 2013-2014. After surgical resection or tissue biopsy, 2 cc of each patient's blood was taken to be sent to laboratory of hospitals. "Nycocard" kit was chosen to measure D-dimer levels in Mg/Lit by neflumetry method. Data were analyzed in SPSS-16 by T-test and One-Way ANOVA test. RESULTS: The highest mean of D-dimer was 3.9 (± 2.9SD) in malignant cervical tumors. The mean plasma levels of D-dimer in malignant uterine cancers (P = 0.008), ovarian cancers (P = 0.007) and cervical cancers (P = 0.006) was significantly higher than benign tumors. In all three types of uterine, ovarian and cervical cancers, D-dimer was significantly higher in advanced stages than lower stages. CONCLUSION: The plasma D-dimer levels in patients with malignant tumors of the uterus, cervix and ovary were higher than benign types. By increasing the stage of gynecologic malignant tumors, the levels of plasma D-dimer were increased.

Portrait representation of postmenopausal women's experiences of living with urinary incontinence.

This study explored the meaning of the experiences of community-dwelling postmenopausal women who were born and grew up in a Muslim country when drawing a picture about their lived experiences of urinary incontinence. Hermeneutic phenomenology underpinned the study's interpretive research approach. In-depth, semistructured interviews were conducted in two sessions with nine postmenopausal women. The participants were asked to draw a picture about their lived experiences of urinary incontinence in a self-portrait. Three themes emerged to illuminate the meaning of urinary incontinence, including "disruption of normal functioning," "self-imposed restrictions," and "feeling of despair." Discussion of these themes was presented, and practice and research implications were suggested.

Heavy metals in water and sediment: a case study of Tembi River.

This study was carried out to examine heavy metals concentration in water and sediment of upstream and downstream of the entry of the sewage to the Tembi River, Iran. Samples were collected from upstream and downstream and were analyzed for Cd, Cr, Cu, Fe, Pb, Ni, and Zn by atomic absorption spectrophotometer. The results indicated that the average concentration of the metals in water and sediment on downstream was more than that of upstream. The comparison of the mean concentrations of heavy metals in water of the Tembi River with drinking water standards and those in the water used for agriculture suggests that the mean concentration of Cu and Zn lies within the standard range for drinking water and the mean concentration of Mn, Zn, and Pb lies within the standard range of agricultural water. The highest average concentration on downstream for Pb in water and for Mn in sediment was 1.95 and 820.5 ppm, respectively. Also, the lowest average concentration on upstream was identified for Cd in water and sediment 0.07 and 10 ppm, respectively. With regard to the results, it gets clear that using the water for recreational purposes, washing, and fishing is detrimental to human health and the environment.

The trend of national and subnational burden of maternal conditions in Iran from 1990 to 2013: the study protocol.

BACKGROUND: It is widely accepted that maternal mortality is a proxy for maternal health status. Maternal deaths only represent the top of the iceberg; morbidity due to maternal causes apart from maternal mortality, poses a huge burden on women's families. There is an excessive need to widen the research on maternal morbidity. Here, we explain the framework of our study on maternal conditions and their burden in Iran as a part of the National and Sub-national Burden of Diseases (NASBOD) study. METHODS: A systematic search will be carried out for both published and unpublished data on maternal mortality and morbidity reported between 1985 and 2013. Data collected through systematic review and those obtained from national and sub-national surveys will be extracted in a data set. Two statistical models will be applied: Bayesian Autoregressive Multi-level models and Spatio-Temporal Regression models. Models will be used to overcome the problem of data gaps across provinces, years and age groups. DISCUSSION: In order to control and manage maternal conditions and to make more efficient and cost-effective policies, there is an excessive need for data on the burden of such diseases. There are a few sub-national analyses of the burden of disease. In the current study, burden of maternal conditions will be assessed at national and sub-national levels in Iran between 1990 and 2013.  The results of this study are undoubtedly required to provide comprehensive information at the national and provincial levels to administer interventions more effectively, since the priority based policies need regional assessments and comparisons.

Study motives and career choices of Iranian medical and dental students.

To compare the study motives and career choices of senior undergraduate medical and dental students in Iran. A cross-sectional questionnaire-based survey study involving final year medical and dental students from 4 dental and medical schools was conducted in 2010. The questionnaire was designed in three sections (Demographic details, motivational items and career choice items) and after confirming the validity and reliability of the questions, it was distributed among the students. Data were entered into SPSS; statistical analysis included logistic regression and multiple linear regression. The response rate was 62% (n=219) for medical and 64% (n=300) for dental students. The factor analysis identified six motivational items: "Social and professional status", "Health care and people", "Others' recommendation", "personal interest and nature of occupation", "Occupational experience" and "Personal life". Medical students were more influenced by "Playing a role in community health" and "Personal interest". "Work independence" and "Social factors" however were two major influential factors among dental students. There were significant differences in important influences by age (Social and professional status, Others' recommendation), Parents' education (Social and professional status, Health care and people, Personal life) and marital status (single >married: Occupational experience, married > single: Personal life). Engaging in postgraduate studies was the first career preference among 90.9% and 89.8% of dental and medical students respectively. Medical and dental students report a wide range of motivational factors in studying medicine/dentistry and future career plans which is affected by age, parents' education and marital status.

Premature ovarian failure in a woman with a balanced 15;21 translocation: a case report.

INTRODUCTION: A case of premature ovarian failure with concomitant findings of Robertsonian translocation between 15 and 21 chromosomes is reported here. The aforementioned karyotypic aberration has not been reported in the context of premature ovarian failure to date. CASE PRESENTATION: We present a case of premature ovarian failure in a 27-year-old infertile Kurdish Iranian woman with a Robertsonian 15;21 translocation. CONCLUSIONS: The diagnosis of premature ovarian failure of unknown etiology, but with karyotypic evidence of a balanced autosomal translocation, suggests the possible role of autosomal genes in the pathogenesis of ovarian follicular attrition.